Percutaneous Nephrolithotripsy (PCNL) has become a standard method to approach large urinary stones (over 2cm) located in the kidney or proximal ureter. Among the minimal invasive urological procedures, PCNL still remains as the most morbid treatment. The routine of using post-operative nephrostomy is still controversial, and some authors supports that tubeless PCNL could be as safe as standard PCNL, with beneficial to decrease pain and hospital stay. Other specialists advocate “total tubeless PCNL” to selected cases, to reduce even more morbidity. This mini-review article has the objective to summarize referenced articles and studies, and provide a conclusive result for clinical practice.