Objective: The aim of this study was to compare the efficacy, access tract dilation time and fluoroscopic time between the one-shot dilation technique and telescopic metal dilatation technique in patients undergoing percutaneous nephrolithotomy in Nakornping Hospital. Materials and Methods: Sixty-six patients who underwent percutaneous nephrolithotomy from January 2020 to July 2021 were included in the study and they were randomly divided into two groups. In group 1 (32 patients), telescopic metal dilation was used, in group 2 (33 patients), the one-shot technique was used. Success rates of dilation, access tract dilation time and fluoroscopic time were evaluated. Results: The success rate of dilation was 100% in both groups. The access tract dilation time was 835.63 ± 309.68 seconds in group 1 and 569.42 ± 314.75 seconds in group 2 (p = 0.001). The fluoroscopic time was 48.16 ± 22.16 seconds in group 1 and 41.97 ± 23.99 seconds in group 2 (p = 0.29). The access tract dilation time of the one-shot dilation technique was statistically significantly shorter than that in the telescopic metal dilatation group. The mean fluoroscopic time of the one- shot dilation technique was shorter than in telescopic metal dilatation but was not statistically significant. Conclusion: One-shot dilation technique is as effective as telescopic metal dilatation, with a significant reduction in access tract dilation time.