Objective: To investigate the status of radiation protection and influencing factors of urologists during percutaneous nephrolithotomy procedures. Methods: A face-to-face survey was conducted among urologists that participated in the 2020 Annual Meeting of Urology of Guangdong Medical Association. A self-designed questionnaire was used to investigate the general information of urologists, the status quo of radiation protection and related influencing factors. Results: A total of 210 urologists from 22 provinces, autonomous regions or municipalities were surveyed and 201 valid questionnaires were collected, the effective recovery rate was 95.71%. The score of radiation protection awareness and measures of urologists during PCNL was 7.86±2.56. Single-factor analysis showed that the influencing factors include the intraoperative fluoroscopy checking, future birth planning, puncture techniques, expansion methods, postoperative fluoroscopy checking, changes in X-ray utilization, puncture location methods, whether familiar with the fluoroscopy settings, methods of controlling fluoroscopy, the fluoroscopy type, the number of shooting frames, and the degree of satisfaction with the quality of the pulsed fluoroscopy image (P<0.05). The dependent variable of P<0.1 in the single-factor analysis was used as the independent variable to perform multiple linear regression analysis. The results showed that the postoperative fluoroscopy checking and the changes in X-ray utilization are the main factors that affect the status of radiation protection of urologists during percutaneous nephrolithotomy procedures (P<0.001). Conclusion: At present, urologists have insufficient knowledge and awareness of radiation protection during PCNL surgery. In response to this problem, the relevant management departments can formulate strategies to strengthen the radiation protection during PCNL surgery, refine the specific measures to reduce radiation during surgery and make radiation protection training closer to the clinic.