Aims and objectives: the present study was conducted to compare prone versus modified supine position in percutaneous nephrolithotomy. Material and methods: The present study is a prospective cohort study conducted in Department of Surgery in Gandhi Medical College and Hamidia Hospital, Bhopal from December 2020 to October 2022. All the patients presenting with renal calculi of size more than 1.5cm or less than 1.5cm with history of failed ESWL or retrograde lithotripsy were included in the study. Results and Conclusion: A total of 30 patients with a median age of 46 years were studied, 15 (50%) underwent PCNL in prone position and 15 (50%) in supine position. There were no significant differences in gender, age, body mass index, stone location, stone size and the presence of hydronephrosis between the two groups. Time from anaesthesia pre-medication to first attempt to puncture the kidney was significantly lower in supine groupas compared to the prone group (32.67mins vs 44.67mins, p<0.05).There was no significant difference in the outcome variables, namely, post-op hemoglobin, days of hematuria, VAS effort score, pain or length of hospital stay. Thus, Modified Supine position allows a reduction in the time needed to position the patient and in the effort sustained by professional nurses, if compared to the prone position. These benefit sallow an optimization of the available resources with economic implications.