Aim: A comparison of pre-operative bladder urine culture with intra-operative Renal stone culture. Material and methods: This was a prospective observational study was conducted at Department of UroSurgery, in Sri Aurobindo Medical College & Postgraduate Institute, Indore (M.P.). A total of 100 cases were taken in the study. All patients with negative pre-operative urine culture were given a single shot of ceftazidime 1g IV 2 h before the urological procedure and patients who had a positive urine culture were treated with antibiotics for 3 to 5 days before surgery based on sensitivity. Stone fragments were aseptically collected during the procedure and were sent for culture and antibiotic sensitivity. Results: Of the 100 cases of urolithiasis enrolled in this study, 62% were male and 38% were female (M/F ratio was 1.63:1) with mean age of 47.25±4.69 years. Among the study population, 27% had a positive pre-operative urine culture, whereas 55% patients were positive for stone culture (Table 2). Most common bacteria isolated in urine culture were E. Coli (33.33%), followed by Pseudomonas (25.93%), Enterococcus (11.11%), Enterobacter (14.81%), coagulase- negative Staphylococcus aureus and Klebsiella 7.41% each). The most common bacteria isolated in stone culture was Pseudomonas followed by Enterobacter, E. coli and others (Table 3). Conclusions: Urine culture has a low predictive value and accuracy when it comes to determining the bacteriology of stone; as a result, it cannot be utilised as a surrogate marker for this condition. When it comes to cases of renal stones, this is where its clinical significance is at its highest.