ObjectiveTo assess the efficacy of ultrasound-guided percutaneous nephrostomy for the treatment of patients with single tuberculous kidney with obstructive ureter. MethodsBetween January 2011 and July 2019, 27 patients who received nephrectomy of one non-functioning tuberculous kidney and had a single tubercuous kidney with obstructive ureter underwent percutaneous nephrostomy under ultrasound guidance at the Department of Ultrasound of the Eighth Medical Center of Chinese PLA General Hospital. The successful rates of punctures and replacement of drainage tube and relevant complications were investigated. Plasma creatinine pre- and post-percutaneous nephrostomy was compared by t-test. Patients' life quality after percutaneous nephrostomy was investigated. ResultsThe successful rate was 100% (55/55) in 55 one-step punctures in 27 patients. Mild bleeding occurred in 92.7% (51/55) of cases, moderate bleeding in 5.5% (3/55), and severe bleeding in 1.8% (1/55). A total of 361 catheter replacements were performed, and the successful rate was 92.2% (333/361). A significant decrease of plasma creatinine was found after percutaneous nephrostomy [(206.4±17.0) μmol/L vs (426.0±50.7) μmol/L; t=5.286, P＜0.001]. All patients could self-care themselves and 21 (77.8%) patients could complete their routine work. ConclusionUltrasound-guided percutaneous nephrostomy is easy to perform, less invasive, and effective for the treatment of patients with single tuberculous kidney with obstructive ureter. The long-term results remain to be investigated.