Percutaneous renal surgery can be utilized as treatment for a variety of urologic conditions. Percutaneous nephrolithotomy remains the treatment of choice for many large and complex renal calculi. Despite having a low overall complication rate, postoperative bleeding can occur. We report a case of significant hemorrhage from a renal pseduoaneurysm in a patient requiring anticoagulation following percutaneous nephrolithotomy. The bleeding was controlled by percutaneous coil embolization. Current management recommendations of postoperative hemorrhage following percutaneous renal surgery are reviewed.