For more than two decades, extracorporeal shock wave lithotripsy technology has been widely used in China. In the southeastern coastal region, extracorporeal shock wave lithotripters can be found not only in large general hospitals, but also in some community hospitals and even in some private clinics. With such a high density of lithotripters, it is reasonable to expect good results, however, the overall results are poor. The reasons for this are three factors: 1. Excessive relaxation of the indications for shock wave lithotripsy In China, there are still a considerable number of hospitals that perform extracorporeal shock wave lithotripsy without perfect preoperative examination, or even lithotripsy based on a single ultrasound test result. On the surface, this seems to reduce the patient’s financial burden while also speeding up the treatment process, but in fact, this often results in a number of undesirable consequences: first, for some patients who do not have the possibility of shock wave lithotripsy and stone removal to receive shock wave treatment, not only does not reduce the patient’s financial burden, but also increases the patient’s unnecessary expenses, and also delays the time for the patient to receive the correct treatment Secondly, imperfect preoperative examination can sometimes lead to serious complications, especially if the patient’s blood clotting mechanism is impaired or seriously infected. At present, domestic lithotripters occupy most of the domestic market with their absolute price advantage, while imported lithotripters with excellent performance are only sporadically distributed in some large hospitals with strong strength. In terms of domestic lithotripters alone, there are significant differences in the positioning system accuracy and shock wave energy output of domestic lithotripters due to differences in production technology standards and process levels of domestic lithotripter manufacturers. Even different models of stone crushers from the same manufacturer may have significantly different crushing efficiency. Therefore, it is difficult to make an overall objective assessment of domestic lithotripters. 3. Operator’s factor In foreign countries, medical personnel engaged in extracorporeal shock wave lithotripsy are trained to obtain the relevant qualifications before they can operate; in China, similar training is far from systematic. This has led to some lithotripter operators in China to “know what they know but not what they know”, which to some extent affects the further improvement of lithotripsy efficiency. I would like to emphasize that a clear preoperative diagnosis and perfect examination are necessary for the implementation of extracorporeal shock wave lithotripsy treatment; and choosing a hospital with a good quality lithotripter and standard operation is an important guarantee for improving the efficacy of lithotripsy.