Background: Extracorporeal shock wave lithotripsy (ESWL)is considered a standard treatment for patients with upper-tract stones that are less than 10 mm in diameter, whereas stones that are larger than 20 mm are best managed with PCNL. The management of kidney stones between these sizes remains controversial. Aim: The aim of this study was to evaluate the prospectively the success of treatment with regards to stone clearance between the two groups ESWL and PCNL in patients with renal stones of size 1-2cm. Material & Methods: This study included 100 patients with moderate-sized kidney stones (range: 1–2 cm) who were posted for surgery for either with PCNL or with ESWL. Success rate, need for auxiliary procedure, duration of hospital stay, retreatment rates, complications, need for blood transfusion and emergency admission were recorded and analyzed. Results: Results of Eighty one patients of renal stones l-2cm size were evaluated in the study with 50 in the ESWL and 50 in the PCNL group . Both the groups were well matched with regards to age and sex distribution. 50 patients underwent ESWL and26/50 patients had stone clearance in 48% months. 50 underwent PCNL out of which 50/47 patients had stone 6% clearance. Complications were mostly minor and found in 8% in patients undergoing ESWL while same were seen in 28% of those undergoing PCNL. Conclusion: PCNL has proved superior to ESWL for renal stones of 1-2 cm in size. It has also got lower auxiliary and retreatment rates but has its own share of complications.