Objective   To compare the clinical effect of standard percutaneous pneumatic nephrolithotomy with combined with holmium laser lithotripsy in the treatment of complex renal calculi.Methods   A retrospectively analysis of clinical data of 170 cases of complex kidney stones who underwent standard channel percutaneous kidney gas pressure ballistic lithotripsy with standard percutaneous nephroscope under air pressure ballistic combined holmium laser lithotripsy removed complexity in our hospital from March 2019 to March 2020 was performed. According to different methods of surgical lithotripsy, they were randomly divided into control group (78 cases) and observation group (92 cases).Control group was treated with standard channel percutaneous nephrolithotomy under pneumatic lithotripsy.  Observation group received standard channel percutaneous nephrolithotomy combined with holmium laser lithotripsy. The operative time, primary stone clearance rate and postoperative average hemoglobin decrease rate were compared between the two groups.Results   The mean operation time of control group was higher than that of observation group, and the difference was statistically significant [(104.85±7.57)min vs.(71.96±9.52)min, P<0.001]. The stone clearance rate of the observation group was significantly different from that of the control group (84.8% vs.69.2%, P=0.015). There were 20 patients (256%) in the control group and 12 patients (13.0%) in the observation group who had decreased hemoglobin after surgery, and the difference between the two groups was statistically significant (P=0.036).Conclusions   The standard channel percutaneous nephrolithotomy combined with holmium laser lithotripsy has the advantages of short operation time, high stone clearing rate in the one-stage operation, and low postoperative hemoglobin reduction.It is worthy of clinical application.