From 1984 to 1998, 808 patients underwent percutaneous nephrolithotomy for removal of renal calculi. Although the technique is safe and effective, complications, including hemorrhages, have been reported. Eight patients (1%) are described in whom severe bleeding following percutaneous nephrolithotomy was uncontrolled by usual methods and treated by hyperselective embolization. Renal arteriography has shown arteriovenous fistula in 3 patients, pseudo aneurysm in 4 and both in1 patient. Embolization allowed definitive treatment of these lesions in 7 of our 8 patients. The failure of embolization in 1 patient imposed a partial nephrectomy. Patients with normal renal function did not suffer significant change in the serum creatinine after treatment (percutaneous nephrolithotomy + embolization), and all but 1 patient have maintained normal blood pressure. In the authors' opinion, hyperselective embolization is the least invasive and best treatment for massive hemorrhage after percutaneous nephrolithotomy.