Hand spasticity after a stroke greatly increases the difficulties of the daily living activities and limits the effectiveness of rehabilitation. Radial extracorporeal shock wave therapy (RESWT) has been suggested as an alternative treatment for spasticity reduction. We demonstrate the effectiveness of RESWT regarding hand spasticity in a stroke patient.We describe the case of a 42-year-old woman with right hemiparesis after ischaemic stroke. Her right arm was plegic with increased spasticity. The patient received a total of six RESWT treatments. Clinical evaluation was performed using the Modified Ashworth Scale, passive dorsal flexion of the wrist and the Disability Assessment Scale (DAS). The measurements were made before initiation, immediately after the sixth treatment, one and three months after the RESWT. Immediately after the RESWT there was a reduction of the spasticity of the hand and fingers and increased passive range of motion of the affected wrist, as well as decreased DAS score. These effects lasted for four weeks. With time, the therapeutic effect regarding spasticity decreased, but three months following termination of treatment there was a better clinical result than before initiation of treatment.RESWT is a safe alternative treatment for hand and fingers spasticity reduction after stroke. Hippokratia 2016, 20(4): 309-312.