Patients routinely undergo chest radiography after percutaneous nephrolithotomy (PCNL) to detect potential hydropneumothorax. 214 patients who had both PCNL and postoperative radiography were analyzed retrospectively. Hydropneumothorax was detected in only two patients, both of whom had clinical signs. As the radiographical findings rarely affect management in practice, the authors recommend that chest radiography can be safely omitted after PCNL.