Urolithiasis is a frequent and common disease in the southern region of China, especially in the Pearl River Delta region, and kidney stones account for 86% of urolithiasis. In the past, it was mainly treated by surgery, which caused great damage and poor therapeutic effect. In February 1980, ESWL was firstly applied in Germany to treat kidney stones with good results. China introduced the technology in 1985, followed by the successful development of domestic lithotripter. It was rapidly popularized and promoted nationwide. The principle of ESWL: When HESW passes through the tissue-stone interface, it generates pulsed high-pressure oscillations due to the sudden change of acoustic impedance, which breaks up the stone.ESWL has become an important treatment for urinary stones because of its non-invasive nature and high success rate. In the early stage of its popularization, it was believed that ESWL had only early reproducible minor damage to the kidneys. However, with the increase in the number of patients treated with ESWL and the prolongation of observation time, it was found that there were some serious long-term complications occurring after ESWL, including renal atrophy, loss of renal function, occurrence of hypertension, stone recurrence, and ureteral stenosis. Application principles of ESWL 1. Stones <2.5 cm in the upper part of the kidney and ureter. It is currently recognized that single stones in the renal pelvis or renal calyx with a diameter of ≤2 cm or multiple stones with a total volume comparable to that of the renal pelvis or renal calyx are the best indications for ESWL; 2. The preferred method for upper ureteral stones. For hard and embedded upper ureteral stones >1 cm, endoscopic lithotripsy is preferred.