Obstructive uropathy is the structural impedance to the flow of urine and can occur at any level from uretheral meatus to the calyceal infundibula. This study compared the ultrasound guided percutaneous nephrostomy (PCN) versus the double J (JJ) ureteral stenting in the management of Obstructive Uropathy, Nephropathy and Hydronephrosis. Objectives were to compare the success rates of JJ stent versus PCN, assess the conversion rates of JJ versus PCN, compare recent complications of JJ versus PCN, compare late complications and failure of JJ versus PCN, compare Quality of Life (QOL) of patients underwent JJ versus PCN.A prospective analytical (comparative) study done in Ibn-Sina Specialized hospital, Sudan. From Dec 2014 to Sept 2015, 83 patients have been included. PCN is a safe procedure and has higher success rate than JJ stent to relief sepsis and decompress the kidney, but it has a higher complication rates on the long run. Moreover, it was found effective in patients with malignant ureteric obstruction. JJ stent needs better setup and more assisting personnel than JJ stent.