Objective：To investigate the therapeutic efficacy of double-J catheter in treatment of renal tuberculosis(TB) and in rescuing the structure and function of the kidney. Methods: Thirty-four patients with renal TB (22 combined with single side hydronephrosis) were divided into 2 groups randomly. Group A were treated with antituberculous therapy and group B with antituberculous therapy combined with pre-treatment with double-J catheter. All 34 patients were followed up for 3 months and were re-examined. Results: The results of B ultrasound, intravenous urogram (IVU), CT and isotope nephrogram were comparable between the 2 groups before treatment, and the results were significantly different between the two groups after 3 months’ drug treatment (P<0. 05). The results of routine urine tests, ESR and the positive rates of urine ABF were not significantly different between the 2 groups (P<0. 05). Nephrectomy was performed in 21 cases, with 15 cases（88.2%） in group A and 6 cases（35.3%）in group B (P<0. 05). Conclusion: Pre-treatment with double-J catheter in the diseased side of patients with renal TB can better preserve the structure and function of the kidney, and can help to lower the rate of nephrectomy.