Abstract: objective: To investigate the clinical and teaching value of 3 D printing technology in the treatment of horseshoe kidney stones with PCNL. Method: Data of 13 horseshoe kidney patients with kidney stones(>2 cm) who underwent PCNL from Mar.2012 to Apr. 2019 in department of urology, Longhua District Central Hospital were collected. Of these, since 2015, we used 3 D imaging software to process patients' CTU test results and printed 3 D horseshoe kidney with kidney stones model by photosensitive resin. Firstly, one surgeon performed preoperative plan based on 3 D printed models and imaging examination data before surgery, and compared preoperative planning and actual process of the operation. Secondly, we divided 10 residents randomly into A and B groups. Group A completed preoperative evaluation base on CT and other imaging data, while group B base on 3 D printed model. Result: The model of horseshoe kidney and kidney stone on the 10 sides of 7 patients were successfully printed. The puncture point and puncture of the renal calyx estimated by the surgeon using the 3 D model were basically consistent with the actual operation. The puncture depth assessed before surgery(5.85±0.47) cm and the actual one(5.90±0.43) cm were not statistically significant(P>0.05). The puncture points in group A were 70%(7/10) consistent with the actual operation, and the puncture caliceal selection was 70%(7/10) consistent. The preoperative evaluation of puncture depth was(6.40±0.75)cm, but the actual one was(5.80±0.43) cm, which the difference was statistically significant(P<0.05).In group B, the coincidence rate of puncture point and puncture of renal calyx with the actual operation was 100%. The puncture depth, preoperative evaluation for(5.75±0.51) cm, actually is(5.80±0.43)cm, with no statistically significant difference(P>0.05). Compared to group A, group B was more likely to be operated by senior surgeons. All piercing angles above were 15 degrees.Conclusion: The 3 D printed kidney with kidney stone model can well simulate the anatomy of the horseshoe kidney, visually reflect the relationship between the stone and the surrounding tissue, and predict the operative process of PCNL in the horseshoe kidney, so it has certain reference value during operation and helps to improve the ability of young surgeons.