In this study, our aim is “to study the determine the outcomes of transurethral nephroscope for the treatment of vesical stones using pneumatic lithoclast”. Material and Methods: The detailed study was conducted in Department of Urology, Islam Medical & Dental College/ Islam teaching/Central hospital Sialkot, from March 2019-March 2020 where we included 25 Male and 5 female who with vesical stones greater then 4 cm that was fragmented using the through transurethral use of a nephroscope via 26F amlplatz sheath. We took history from medical cards and conducted physical examinations, lab tests, urine culture and ultrasonagraphy of urinary tract. Then using the x-ray KUB film for stone clearance. We noted the mean age, operation time, presenting symptoms, complications and the post operative status of the stone clearane, and conducted our analysis using SPSS version 20. Result: The mean age ± SD was noted to be 48.79±12.499 years and male to female percentage being 89% to 11%. The mean stone size was 4.53±0.38 cm and mean operation time was 48.79±8.73 minutes. Thirty-one patients (31%) developed retention of urine and straining during micturition in (17%), dribbling of urine (15%) , hematuria (10%), frequent urination(10%) and abdominal pain was reported in 15% patients. Ninety-six (96%) patients achieved the stone-free status and had no complications while only 1 patient had an intravesical bleeding. Conclusion: We conclude that treatment of large stone using a nephroscope via a transurethral amplatz sheath is an effective procedure and quick too.We also noticed that the Amplatz sheath helps in pneumatic lithotripsy is indeed an effective and safe procedure to be carry out in patients with large bladder stones.