Objective  To systematically evaluate of the effectiveness and safety of percutaneous nephrolithotomy(PCNL) with concurrent aspiration in the treatment of renal calculi.Methods  The randomized controlled trials of PCNL with concurrent aspiration for the treatment of kidney stones were systematically retrieved from PubMed, The Cochrane Library, Embase, CNKI, Wanfang, Chinese biomedical literature and VIP database through computerized searches. The search period ranged from the inception of each database to September 3, 2022. Independent screening of literature, data extraction and quality assessment were conducted by two researchers. Meta-analysis was performed  using RevMan 5.4 software.Results  The study included a total of 11 literature sources, encompassing 1 434 patients with kidney stones. There were 720 cases in PCNL with concurrent aspiration group and 714 cases in PCNL without aspiration group. Meta-analysis results demonstrated that percutaneous nephrolithotomy with concurrent aspiration exhibited superior outcomes compared to the PCNL without aspiration group, specifically in terms of stone clearance rate, operative time, intrapelvic pressure, intraoperative blood loss, and postoperative fever. These differences were statistically significant (all P<0.001).Conclusions  Compared to PCNL without suction, PCNL with concurrent aspiration can effectively improve stone clearance rate, shorten operation time, reduce intraoperative renal pelvis pressure, reduce intraoperative blood loss, and reduce postoperative complications such as fever.