Background: Staghorn stones are large branching stones that fill part of all of the renal pelvis and renal calyces and they can be complete or partial depending on the level of occupancy of the collecting system. Management of staghorn stone is still challengeable. There are seven alternatives for managing staghorn calculi, including: Medical therapy alone, Open surgery, Anatrophic nephrolithotomy (AN),Chemolysis or stone dissolution therapy, Percutaneous nephrolithotomy (PNL),Shock-wave lithotripsy (SWL) ,Combination of PNL and SWL(sandwich technique) ,endoscopic combinedand intrarenal surgery (ECIRS) Methods: This prospective single center cohort interventional study was carried out on 68adult patients having staghorn stone From June 2022 to June 2023. Results: On univariate analysis, it was found that age, stone shape, Hounsfield unit (HU unit), complexity, staghorn stones, recurrence, and operative time were significant factors affecting SFR. While multivariate analysis found that operative time was significant factors affecting SFR Conclusions: PCNL is the method of choice for treating staghorn stones, It should be done in a specialized center with facilities for the management of stones and treatment of any consequences.