Abstract: Objective To investigate the risk factors of the serious complications related with double-J ureteral stent placement following percutaneous nephrolithotomy (PCNL). Methods Clinical data were reviewed for 272 patients treated with PCNL and indwelling double-J stents between January, 2014 and April, 2016. The risk factors of serious complications were identified using univariate and multivariate logistic regression analysis. Results Serious complications of double-J ureteral stenting occurred in 63 patients (23.1%). Univariate and multivariate logistic regression analysis indicated that the ureter abnormalities (β =1.735, P=0.000, OR=5.670), stent indwelling duration (β =1.206, P=0.028, OR=3.340), gender (β =0.895, P=0.016, OR=2.446), preoperative urinary tract infection (β =0.849, P=0.020 , OR=2.338) and stent size (β =0.847, P=0.011, OR=2.333) were all risk factors of serious complications related with the procedure. Conclusion Male patients are exposed to a higher risk of serious complications following PCNL. Effective management of urinary tract infection and choice of appropriate stent size in cases of ureteral abnormalities help to reduce these complications. The double-J stent should be withdrawn as soon as possible in patients with good postoperative recovery.