Percutaneous nephrolithotomy (PCNL) has become the standard treatment for large and complex kidney stones since its introduction in 1976. On the other hand, postoperative complications are not rare and can be quite significant. Of these complications, postoperative infectious complications, such as systemic inflammatory response syndrome (SIRS), remain a seminal event and a possible cause of perioperative mortality. Several recent studies have found a number of factors that increase the risk of SIRS after PCNL. These include preoperative factors (patient’s characteristics) and factors associated with the intraoperative and postoperative findings. The present study describes the perioperative risk factors of SIRS after PCNL. These findings can help decrease the incidence of infectious complications, including SIRS, in patients undergoing PCNL.