Abstract: Objective Tosummarize the methodand experience of retroperitoneoscopic nephrectomy for tuberculous kidneys. Methods FromJanuary 2008 toAugust 2014, retroperitoneal laparoscopic were performedin 158 cases with tuberculous kidneys (77 men and 81 women with mean age of 42 years, range 21- 63 years), including 5 cases with Home-made Single-port Retroperitoneal Laparoscopic Nephrectomy. Severely destructive changes in all cases were foundunder renal CT, which needantituberculosis therapy for at least 15 days before operation and routine pathological examination after operation. Results Of the 158 cases confirmedby pathology of renal tuberculosis, retroperitoneal laparoscopic nephrectomy were successfully completedin 150 cases while other 8 cases (5.1%) convertedtoopen surgery. The average sedimentation rate was 43 mm/L (6-80 mm/L) and C-reactive protein was 15.5 mm/L (4-25 mg/L). Urine-Tuberculosis showedpositive in 61 cases (38.5%), negative in 97 cases (61.4%). The average GFR in diseasedkidney was 37.45 ml/min (9.6-65.3 ml/min). The average operation time was 95 min (55-135 min) and the average intraoperative hemorrhage was 110 ml (70-150 ml). Home-made Single-port Retroperitoneal Laparoscopic Nephrectomy was successfully completedin 5 cases without conversions toopen surgery. All patients recoveredafter operation with an average hospitalization time of 13.5 d(7-20 d), only 1 case hadabdominal tuberculosis infection, nodisseminatedtuberculosis infection and formation of tuberculosis sinus tract were foundduring an average follow-upperiodof 37 months (2-72 months). Conclusion The resection of renal tuberculosis is preferredduring retroperitoneal laparoscopic surgery, which is safe and effective toretroperitoneoscopic nephrectomy for tuberculous kidneys. There are some difficulties in operation such as separation of renal vascular and perirenal space, avoiding tuberculous lesions rupture and tuberculous ureteral processing.