Percutaneous nephrostomy (PCN) is a well-established method for temporary urine drainage. Furthermore, it enables minimally invasive alternatives for therapy of a number of urologic conditions. Also, primarily inoperable patients can be converted into an operable condition. Computed tomography (CT)-guided PCN has the lowest complication rate of all methods and is especially, indicated in patients with a non-dilated collecting system or after unsuccessful drainage attempts under fluoroscopy or ultrasound guidance. Magnetic resonance (MR)-guided percutaneous nephrostomy (PCN) is restricted to special cases such as allergic patients in whom CT- or ultrasound (US) guidance is contraindicated or not possible.