Due to its particular anatomical position below the ureteropelvic junction, the lower pole group of calices plays a special role in the treatment of nephrolithiasis. The extracorporeal shock-wave lithotripsy (ESWL) often attains dissatisfactory stone-free rates, even after optimal disintegration of lower pole stones, and thus necessitates secondary therapeutic procedures. Due to the favorable stone-free rates, retrograde intrarenal surgery with its low complication rate has taken up an important role in the treatment of lower pole stones since the development of modern flexible ureterorenoscopes. The long treatment times in the case of a large stone burden and considerable costs for materials constitute limiting factors. In line with the advancement of percutaneous nephrolitholapaxy (PCNL), a promising method also for the treatment of larger lower pole stones is available today with minimally invasive PCNL (MIP).