Objective  To investigate the clinical efficacy of double and single color Doppler ultrasonography position combined with preoperative urinary CT in percutaneous nephrolithotomy(PCNL) on upper urinary calculi.Methods  From January 2015 to May 2023, 219 patients with upper urinary calculi underwent PCNL in our hospital were collected. The patients were divided into color ultrasound double plane positioning group (112 cases) and color ultrasound single plane positioning group(107 cases) according to different color ultrasound positioning methods. Both groups were operated by the same surgical team. The mean puncture times, puncture time, channel length, lithotriptic time and surgical bleeding were observed in the two groups. The success rate of one time puncture, satisfaction of surgical field and stone clearance were compared between the two groups. The incidence of postoperative complications was recorded in both groups.Results  The puncture times and surgical bleeding in the color ultrasound double plane positioning group were less than those in the color ultrasound single plane positioning group. The one-time puncture success rate, the clarity of surgical field and the stone clearance rate were higher than those in the color ultrasound single plane positioning group, while the puncture time, channel length and lithotriptic time were shorter than those in the color ultrasound single plane positioning group (all P<0.05). There was no significant difference in renal segment artery injury and abdominal fluid accumulation between the two groups [0 vs. 0.93% (1/107),0 vs. 1.87% (2/107), P=0.869, 0.638].Conclusions  Color ultrasound biplanar location combined with preoperative urinary CT is a safe and efficient location method in percutaneous nephroscopy, which is more effective than single planar location.