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Abdominal compartment syndrome is a life-threatening complication of conventional percutaneous nephrolithotomy (PCNL), with few cases reported in different positions. We present the first case of abdominal compartment syndrome as a complication of supermini percutaneous nephrolithotomy (SMP) in The Galdakao-modified supine Valdivia position, possibly predisposing factors, diagnosis, and management.Although it is a challenging diagnosis and life-threatening condition, morbidity and mortality can be decreased with early detection and drainage of the intra-peritoneal fluid, causing increased abdominal pressure, which is the most important prognostic factor.