Percutaneous nephrolithotomy (PCNL) is a well-established procedure for treating nearly all types of stones in the kidneys and middle-to-upper ureters. In addition, PCNL is less invasive, and provides safe results comparable to open surgery. However, there is risk of an increased risk of thoracic complications when performing a puncture above the 12 th rib to optimize kidney access. We experienced a 30-years-old female who had oxygen desaturation and complained dyspnea and chest pain at the postanesthetic care unit after percutaneous nephrolithotomy. Therefore, patients undergoing percutaneous renal manipulation need to be monitored for pulmonary complications during and after the procedure.