Since the 1980s, extracorporeal shock wave lithotripsy (ESWL) has been widely used to treat kidney and ureteral stones with satisfactory results and has gradually replaced open surgery. ESWL is suitable for stones less than 2 cm in diameter in the upper or middle calyces of the kidney and for stones less than 1 cm in diameter in the upper ureter. Although ESWL is not harmful to the body, not all patients with urological stones can be treated with ESWL. For example, pregnant women and those with bleeding tendency are not suitable for ESWL. for patients with long duration of disease, large stones, high stone location and combined obstruction ureteral stones, in principle, ESWL should not be performed more than 2 times, if there is still no effect, ureteral lesions around the stones should be considered and ESWL must be abandoned. ESWL only breaks up the stones, but even small fragments of stones may block the ureter, thus causing “stone steps”, causing hydronephrosis and perinephric infection, back pain, fever and other discomforts. Most ureteral stones are treatable with ESWL. However, practice has confirmed that if the stone stays in the ureter for too long, the stone will form a polyp underneath the stone and wrap around the stone with prolonged stimulation. At this time, even if the stone is broken by ESWL, the stone cannot be discharged because the polyp is blocked underneath the broken stone. In this case, even if the stone is broken by ESWL, the stone cannot be discharged because the polyp is blocking the stone. Therefore, careful history should be taken before ESWL to understand the location, size, retention time and hydronephrosis of the stone to decide the treatment method. In principle, ESWL should not be performed more than 2 times, and if there is still no effect, the ureteral lesion around the stone should be considered and ESWL should be abandoned.