Bladder stones are the most common calculi of the lower genitourinary tract (1). The most common predisposing factor is the bladder outlet obstruction. The present case, is about a patient, who suffered urethral trauma after a pelvis fracture, requiring a Mitrofanoff urinary diversion; who was diagnosed with multiple cystolithiasis up to 1 cm. The objective of these paper is to show the possibility of performing a percutaneous cistolithotomy in a patient with a complex urinary diversion, being a less morbid intervention, with shorter recovery time and comparable results in terms of stone free percentage rate. The procedure starts previous Mitrofanoff catheterization with a Foley catheter 12. Ultrasound-guided suprapubic left paramedian puncture was performed followed by Chiba needle hydrophilic guidewire, stiletto, telescoped Alken dilators 9Fr-22Fr and 28Fr Amplatz shirt. Once established percutaneous tract, the nephroscope and foreign body forceps were introduced and complete stone removal was achieved. The procedure ended with the extraction of the Amplatz shirt and occlusion of the wound with gauze dressing, maintaining the bladder derivative with the Foley catheter to a draining collector system. Discharge was given at day 1 postoperative Foley catheter was removed after 5 days. No complications occurred, the operative time was 1 hour, and 1 day of hospitalization. Satisfactory recovery with a successful outcome in terms of complete stone removal in only 1 surgery. Percutaneous cystolithotomy is a management option which offers advantages comparable with other techniques. Must be considered not only in patients with urethral restricted access.