Objective To evaluate the safety and management of renal severe hemorrhage with percutaneous nephrolithotomy （PCNL）. Methods 5 472 cases undergone PCNI, from June 1993 to October 2004 were analyzed retrospectively,in which 39 cases found severe hemorrhage. Results 12 cases were treated with embolization and 2 cases with early nephrectomy, and the rest of 39 cases were cured conservatively .Conclusion The frequency of severe hemorrhage with PCNL is lower and the best treatment for severe hemorrhage is interventinal embolization.