The authors review the problem of staghorn nephrolithiasis (SN) basing on their experience in the disease diagnosis, treatment and prevention. Basing on the analysis of 2021 cases (1354 females and 667 males), the data on SN etiology and pathogenesis are provided. A complex of diagnostic procedures, an original classification, differentiated indications to various conservative or surgical treatments, trends in prevention of nephrolith reappearance, promising research approaches are outlined.