The results of surgical treatment of pyodestructive pyelonephritis in 105 (4.2%) pregnant women and puerperae out of 2506 ones treated in the urology department from 1986 to 1994 are analyzed. Uni- and bilateral apostematous nephritis, carbuncle and abscess of the kidney were diagnosed in 89 and 16 patients, respectively. Nephrostomy was the principal method of treatment of focal suppurative forms of acute pyelonephritis. Bilateral nephrostomy was carried out in 12 pregnant patients, in 3 of them secondary nephrectomy was performed. Nephrectomy is indicated in total destruction of the kidneys, it was made in 37 (35.2%) pregnant women and puerperae. Introduction of radical surgery into practical treatment of neglected forms of pyodestructive pyelonephritis led to almost total liquidation of postoperative mortality in pregnant women. The efficacy of treatment of pregnant women is provided by varying in extension surgical interventions on the kidneys. Organ-sparing and radical operations in grave purulent pyelonephritis were effective in 97.2% of pregnant patients.