Abstract: Percutaneous nephrolithotomy (PCNL), as a first-line minimally invasive treatment for complex renal calculi, is associated with a postoperative incidence of systemic inflammatory response syndrome (SIRS) as high as 10%-30%. SIRS may progress within hours to sepsis or even septic shock, posing a serious threat to patients’ lives. Previous studies on predictors of SIRS after PCNL have mostly focused on individual indicators, with insufficient systematic integration of multidimensional predictive factors. Based on the latest evidence from China and abroad over the past five years, this study systematically reviews recent research advances in predictors of SIRS after PCNL from seven dimensions: preoperative bacteriological assessment, surgery-related factors, baseline patient status, composite inflammatory markers, nutritional and immune assessment indicators, imaging and anatomical parameters and machine learning prediction models. This study proposes an evidence-based graded risk assessment workflow for perioperative SIRS in PCNL and corresponding differentiated perioperative management strategies. It transforms abstract predictive factors into quantifiable and operable clinical decision-making tools, providing evidence-based references for clinicians to accurately identify high-risk patients, formulate individualized perioperative plans, optimize prophylactic anti-infective strategies, and reasonably determine the intensity of monitoring. These findings have important clinical guiding value for reducing the incidence of SIRS after PCNL and improving patient prognosis.