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The stone-free rate was 67.5% in the GA group and 70.0% in the SA group ( = 0.81). The use of auxiliary procedures within 90 days did not differ between groups (25.0% vs. 22.5%, = 0.79). No cases of conversion from SA to GA were recorded. We did not find any differences in intraoperative bleedings, perforations, and abortions. Complication rates were similar in the 2 groups (10.0% in GA vs. 5.0% in SA, = 0.64). In our cohort, RIRS performed under SA and GA was equivalent in terms of surgical results and complications.