19 Percutaneous nephrolithotripsy procedures were done in 15 children aged from 8 months to 16 years with complex renal stones and/or extracorporeal shock wave lithotripsy refractory stones. The percutaneous techniques were done with the instrument and position (prone and supine) used in adults. 14/15 patients were stone-free (13 pts in one time, 1 pt in 2 procedures and 1 pt, with complex bilateral stones disease, in 5 endourological sessions). No relevant complications developed: 1 patient need a blood transfusion and 1 a temporary Indwelling catheter for colic pain due to oedema. We believe that in children the endourological approach is better than traditional open surgery or reiterated extracorporeal shock wave lithotripsy sessions which often need anaesthesia and can not guarantee a complete clearance of the stones.