Objective: Urolithiasis is an important disease that can lead topermanent kidney dysfunction and severe clinical symptoms inpediatric patients. We aimed to present our findings of rigidureteroscopy combined with Holmium YAG laser lithotripsy.Material and Methods: We retrospectively reviewed theultrasonography, and medical records of pediatric patients withurolithiasis who were operated in Sutcu Imam UniversityDepartment of Pediatric Surgery, Kahramanmaraş betweenApril 2018 and December 2019.Results: Sixty-one pediatric patients (M/F=38/23) withurolithiasis were enrolled in this study. The mean age was6.7±4.9 years (range 3 month-17 years). Thirteen (34.2%) malepatients need an urgent operation (rigid ureteroscopy combinedwith Holmium YAG laser lithotripsy) while the correspondingnumber was 4 (17.4%) in female patients. The differencebetween two sexes was statistically non-significant (p=0.156).Thirty-two male patients (84.2%) and 12 (52.2%) femalespatients had a successful operation (rigid ureteroscopy combinedwith Holmium YAG laser lithotripsy). The difference betweenthe two sexes was statistically significant (p=0.019). The ratio offemale patients with right-sided stone was significantly greaterthan the corresponding rates of male patients (p=<0.001). Therewas no difference between infants (<3 years of age) and toddlers(>3 years of age) with respect to gender, side of stone, proceduralsuccess, and need for urgent surgery (p>0.05). Regressionanalysis showed that female gender was a risk factor for a failedattempt (OR=-0.313, 95% CI: 0.052 – 0.528; p=0.0018).Conclusion: Safe and effective stone treatment can beperformed considering that more than one operation can beperformed in infants and children with mini ureteroscopy andholmium laser. However, while evaluating this treatment optionin female patients, alternative treatment methods such as flexibleor percutaneous nephrolithotomy may be preferred.