Ureteroscopy (URS) and percutaneous nephrolithotomy (PCNL) are two surgical treatment options for the management of intermediate-size (15-20mm) kidney stones. Given there are differences between these two procedures in surgical technique, stone-free rates, and complication risks to name a few distinctions, physician to patient counseling often plays an important role in the shared decision-making process before deciding on which procedure is the best option for the patient. While there are a number of factors urologists take into consideration before operating (anatomical factors, stone characteristics), in the case of intermediate-size kidney stones, where URS and PCNL are often both reasonable options the ultimate choice often comes down to individual patient preference.