Abstract: Objective To investigate the risk factors of systemic inflammatory response syndrome (SIRS) after percutaneous nephrolithotomy (PCNL) for upper urinary tract calculi. Methods Clinical data about 267 cases who had undergone percutaneous nephrolithotomy in our department from May 2012 to September 2015 were retrospectively analyzed.Univariate analysis and Logistic regression analysis were performed to assess the risk factors of postoperative SIRS. Results Of the 267 patients, 41(15.4%) cases had SIRS manifestations including 4 cases of septic shock.After anti-infection and symptomatic treatment, all patients were fully recovered without dead cases.In univariate analysis, a history of recurrent urinary tract infection, operative time, stone burden and staghorn calculi were related to postoperative SIRS.Logistic regression revealed that preoperative recurrent urinary tract infection history (OR=6.759, P＜ 0.01) and staghorn calculi (OR=6.501, P＜ 0.01) were independent risk factors for postoperative SIRS. Conclusion Doctors should be more vigilant to those with recurrent urinary tract infection history and staghorn calculi.Preoperative infection control, intraoperative aseptic technique, avoidance for collecting system damage and postoperative close monitoring are beneficial to reducing the incidence of SIRS.