Objective：To describe two cases of postoperative septic shock after endoscopic combined intrarenal surgery (ECIRS) that were managed well by early recognition and early intervention by anesthesiologists. Case presentation： ［Case 1］ECIRS was performed to treat a stone in the left kidney of a 56-year-old woman. She fell into a state of shock immediately after removal of her tracheal tube in the operating room. She was diagnosed with sepsis based on quick SOFA score and other findings and was treated in the intensive care unit for three days.［Case 2］ECIRS was performed to treat stones in the right kidney of a 39-year-old woman who suffered from recurrent urinary tract infections. After the procedure, her condition deteriorated during her stay in the postanesthesia care unit. She was treated in the intensive care unit for three days for septic shock. Conclusion：Although its incidence is rare, septic shock is one of the most important complications associated with patients who have undergone ECIRS.