Abstract. Nephrolithiasis affecting patients with stones up to 2 centimeters in diameter represents one of the most prevalent urological conditions encountered in clinical practice. The management of renal calculi of this size range sits at a critical therapeutic crossroads, where multiple minimally invasive and endoscopic surgical options are available, yet no universally accepted consensus exists regarding the optimal treatment algorithm. Shock wave lithotripsy (SWL), ureteroscopy with laser lithotripsy (URS), and miniaturized percutaneous nephrolithotomy (mini-PCNL) each offer distinct advantages and limitations depending on stone characteristics, patient anatomy, and institutional resources.