Background: The aggregation of a solid crystalline material in the urinary tract i.e. kidney is called urolithiasis or kidney stone disease. Ultrasonic and pneumatic lithotripsy are the two methods done with PCNL to remove kidney stones. But there was no data available in local literature. So we conducted this study to assess the more beneficial method for local setting. Objective: To compare the ultrasonic and pneumatic lithotripsy in PCNL for kidney stones in terms of stone clearance rate and residual stone fragments. Material & Methods: Study design: Randomized control trial Setting: Department of Urology Lahore general hospital Duration of study: 12 months i.e. from (15-10-2016) to (15-10-2017). Data collection: 50 patients enrolled in this study. All admitted patients would be diagnosed on the basis of history, clinical examination, baseline investigations and some specific investigations like urine culture &sensitivity, USG KUB, plain X-rays KUB, IVU and CT-scan KUB if needed. The patients were divided into two groups. One is treated with Ultrasonic lithotripsy and the other is with Pneumatic lithotripsy. All the collected data was entered and analyzed SPSS 21. Results: In ultrasonic Lithotripsy group, the mean age of patients was 38.76±12.95years and in pneumatic Lithotripsy was 38.12±13.78years. There were 24(48%) male patients and 26(52%) female patients. In ultrasonic lithotripsy group, stone clearance was achieved in 19(76%) patients while with pneumatic lithotripsy, stone clearance was achieved in 11(44%) patients. Conclusion: Thus ultrasonic lithotripsy is superior to pneumatic lithotripsy in PCNL in stone clearance and had better outcome.