Objective To investigate the clinical effect of minimally invasive surgery in patients with upper urinary calculi and renal empyema and its effect on renal function. Methods Eighty-four patients with upper urinary calculi and renal empyema admitted from April 2016 to March 1818 were enrolled. The random number table was divided into control group and observation group, 42 cases in each group. The control group was treated with ureteroscopic lithotripsy. The observation group was treated with microchannel percutaneous nephrolithotomy. The effect of the patients was evaluated 3 days after surgery. The 7600 automatic biochemical analyzer was used to measure the levels of urea nitrogen, serum creatinine (Scr) and 24 h urine protein (24 h UP) before and after treatment. The enzyme-linked immunosorbent assay was used to measure the two groups before and after surgery. Hypersensitive C-reactive protein, tumor necrosis factor-a (TNF-a), interleukin-6 (IL-6) levels, and endothelin (ET-1) levels, serum of patient was completed by enzyme-linked immunosorbent assay (ELISA) Cortisol (CORT), catecholamine (CA), plasma glutamate (GLU) levels, statistics and re-corded the incidence of stone clearance, septic shock, perirenal abscess, major bleeding and sepsis in the two groups. Effects and effects on renal function in patients. Results The levels of BUN, Scr and 24 h UP in the observation group were lower than those in the control group 3 days after surgery (P 0.05). The incidence of septic shock, perirenal abscess, massive hemorrhage and sepsis after operation was lower in the observation group than in the control group (P<0.05). Conclusions Microchannel percutaneous nephrolithotomy for upper urinary calculi with renal empyema can improve the renal function of patients, reduce inflammatory factors and stress response, and the incidence of postoperative complications is low. It is worthy of popularization and application. Key words: Urinary Calculi; Pyonephrosis; Minimally Invasive Surgical Procedures