Introduction– The evolution of percutaneous nephrolithotomy (PCNL) has been well documented. The objective of the present study is to ensure optimum access to the renal collecting system, allowing for endoscopic combined retrograde intrarenal surgery (ECRIS), reducing operative time and anesthetic morbidity during PCNL. Method– Patients with renal calculus/calculi were selected randomly. There were no age, gender; size, location and laterality of stone or BMI preferences. All the patients fit into the AUA guideline criteria for management by PCNL. Results– 15 patients underwent supine PCNL in 6 months in Galdakao modified Valdivia position. There was no intra or post operative complication in any patient. In all the patients stones were cleared completely in single sitting. Conclusion– Supine PCNL is advantageous in many ways of which major ones are ECRIS, time saving, less anesthesia complications and with spine deformity patients.