Objective To investigate the incidence rate of acute kidney injury（AKI） after percutaneous nephrolithotomy（PCNL），analyze the risk factors for AKI after PCNL，and propose related prevention and treatment measures. Methods A retrospective analysis was performed for the clinical data of the patients who underwent PCNL in Department of Urology，The First Affiliated Hospital of Chongqing Medical University，from January 2014 to October 2022，and according to the increase in the level of serum creatinine after surgery，the patients were divided into AKI group and non-AKI group. Univariate and multivariate logistic regression analyses were used to investigate the risk factors for AKI after PCNL. Results A total of 628 patients were included in the study，among whom 43 developed AKI after PCNL，resulting in an incidence rate of 6.8%（43/628）. The univariate analysis showed that compared with the non-AKI group，the AKI group had significantly higher mean age，preoperative serum creatinine，serum uric acid，and urine white blood cell count，a significantly higher severity of hydronephrosis，a significantly lower level of hemoglobin before surgery，and a significantly higher proportion of patients with positive urine culture before surgery，renal atrophy，bilateral upper urinary tract calculi，stag-horn calculi，calculi with pyuria，postoperative urosepsis，and postoperative transfusion（P<0.05）. The statistically significant indicators identified by the univariate analysis were included in the multivariate logistic regression analysis，and the results showed that the increase in the age of the patient（odds ratio［OR］=1.043），preoperative renal insufficiency（OR=1.021），bilateral upper urinary tract calculi（OR=3.582），stag-horn calculi（OR=3.590），and postoperative urosepsis（OR=5.543） were independent risk factors for AKI after PCNL. Conclusion The incidence rate of AKI after PCNL is 6.8% in our center. The increase in age，preoperative renal insufficiency，bilateral upper urinary tract calculi，stag-horn calculi，and postoperative urosepsis are independent risk factors for AKI after PCNL. These risk factors should be taken seriously in clinical practice，and active measures should be adopted to prevent postoperative AKI.