This is a rare case of a large cast stone in the kidney: Zhang Moumou, a 45-year-old woman, presented to the hospital with “hematuria of the naked eye for half a month”, and ultrasound and X-ray examination showed cast stone in the right kidney and hydronephrosis. After the patient was admitted to the hospital, she underwent percutaneous nephrolithotripsy of the right kidney, which was a smooth operation that lasted 3 hours, and the KUB plain film showed that there was no residual stone. The patient was discharged one week after the operation. Pre-operative CTU: cast stone of right kidney Pre-operative KUB film: cast stone of right kidney Post-operative KUB film (Siemens Urological X-ray diagnostic system): no residual renal stone EMS lithotripsy system: the bottle contains the stone removed after crushing (total volume 300ml).