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Objectives: To assess the feasibility of performing percutaneous nephrolithotomy (PCNL) with the patient supine. Although PCNL with the patient prone is the standard technique for treating large (>2 cm) renal stones including staghorn stones, we evaluated the safety and efficacy of supine PCNL for managing large renal stones(upto 2.5cm), with special attention to evaluating the complications. Materials & Methods: In a prospective study between March 2015 and March 2016, 60 patients with large renal stones underwent cystoscopy with aureteric catheter inserted, followed by puncture of the collecting system while they were supine. Tract dilatation to 24 F was followed by nephroscopy, stone disintegration using pneumatic lithotripsy, and retrieval using a stone forceps. All patients had a nephrostomy tube placed at the end of the procedure. Results: The median (range) operative duration was 120 (90–210) min, and the mean (SD) volume of irrigant was 18.2 (3.7) L. One puncture/two punctures were used to enter the collecting system and clearance was considered with fragments <5mm.We achieved total clearance in 54 out of 60 patients (90%). Conclusion: Supine PCNL is technically feasible; it has several advantages to patients, urologists and anaesthesiologists. It gives stone-free rates and a low incidence of organ injury comparable to those in standard prone PCNL