In most cases, analgesia is required for extracorporeal shockwave lithotripsy (SWL) treatment. Commonly, a combination of a sedative and a synthetic opioid is used, with a wide range of undesirable side effects. To provide an alternative analgesic especially for outpatients, we performed a prospective trial investigating the usefulness of acupuncture.A series of 90 patients were included in the study, 49% of whom presented with renal calculi and 10% with proximal-, 10% with middle-, and 31% with distal-ureteral stones. Pain control was performed by acupuncture in the traditional Asian method. The intensity of pain and patient satisfaction were assessed a visual analog scale (VAS). Patients with previous SWL under conventional analgesia also were asked about differences in pain and satisfaction.No significant side effects occurred. The median pain score on the VAS was 2/10 (interquartile range 1). Six patients (6.6%) specified a pain intensity of >4, and in 4 patients (4.4%), a conventional analgesic had to be given to finish SWL. The median satisfaction level was 2/5 (interquartile range 1). Nearly all (93.4%) of the patients would opt again for acupuncture in case of repeated SWL.In many patients, acupuncture achieves satisfactory pain control for SWL. Further randomized multi-institutional studies are needed to confirm this conclusion.