Aims and background: Nephrectomy for xanthogranulomatous pyelonephritis (XGPN) is inherently difficult due to the loss of fat planes and fibrosis; thus, traditionally, an open approach was recommended. Our objectives are to evaluate the safety of laparoscopic nephrectomy in XGPN, to determine the predictors of conversion from laparoscopic to open nephrectomy in XGPN, and to compare the perioperative outcomes and complications of laparoscopic and open nephrectomy for XGPN. Materials and methods: A retrospective review of 103 patients with a pathological report of XGPN who underwent nephrectomy between 2013 and 2022 in our hospital was done. A total of 65 patients had open nephrectomies, 26 had laparoscopic nephrectomies, and 12 had laparoscopic nephrectomies that were converted to open surgery. Open nephrectomy was performed using the extraperitoneal approach, and laparoscopic operations were performed via the transperitoneal route. Results: Laparoscopic nephrectomy was successful in most patients, with a conversion rate of 31.6%. The most common reason for conversion was difficulty in progression. Laparoscopic nephrectomy was equally safe, with comparable postoperative outcomes, similar operative time, and length of hospital stay. Patients with anemia, loss of fascial planes on CT, and hilar lymphadenopathy had a higher chance of conversion. Conclusion: Laparoscopic nephrectomy for XGPN was equally safe when compared to open nephrectomy with regard to intraoperative and postoperative outcomes. Well-chosen patients with XGPN can benefit from the laparoscopic approach more than from the traditional open approach. Clinical significance: Laparoscopy is equally safe for XGPN, and preoperative imaging can serve as a clue for selecting the appropriate surgical approach.