Objective: To investigate the efficiency and feasibility of retrograde intrarenal surgery (RIRS) for treatment of avation pilot renal stones. Introduce the initial experience to due with this kind of case in our center. Methods 32 cases( 34 sides)of “pilot renal stones” were treated with RIRS during 2010 and 2013. Right 16 cases and 18 cases left. 16 cases of single stone and 18 cases of multi stones. Patients are all male, with average age of 25.2 years old( range from 19 to 44). Maximum diameter was 5mm( Range from 3mm to 11mm). Operations were performed under electron microscopy ( STORZE) or percutaneous nephrolithotripsy(PCNL) . Ureteral stent was placed one week before surgery. For residual stones, two-stage RIRS and/or PCNL were choosed. The safety, stone clearence rate and perioperative parameters were evaluated. Results: Patients were all underwent RIRS successfully except 2 cases of PCNL. Mean operative time was 56min(Range from 30 to 135mins), Postoperative incharge days were 2.8 (Range from 1 to 10). 29 cases received one stage operation and 3 cases two-stage. PCNL was performed in two patient finally. Postoperative computed tomography was performed. The general stone-free rate was 97%, and the rate of RIRS was 94%.. Conclusion: Retrograde intrarenal lithotomy for pilot kidney stones is safe, with definite efficiency. This technique can be used as the first therapy to due with this kind of stones.