Extracorporeal shock wave lithotripsy (ESWLs) results can be enhanced by the application of specific technological concepts and the selection of advantageous instances. This study's goal is to analyze the mechanisms of action of ESWL., indications and contraindications, success predictors, and consequences. ESWLs & "calculi" were used as topics in a search between Jan. 1984 and Oct. 2013 in the Pubmed® database. Only human-conducted studies with a sufficient level of evidence, including clinical trials or reviews/meta-analyses, were considered for inclusion. To optimize the seek for the ESWL results, many technical factors, including the kind of ESWLs apparatus, the intensity & frequency of the impulses, the connecting of patients to the device, the position of the stones, as well as the type of anesthesia, should be taken into consideration. Other patient-related variables, such as the density & size of the stone, skin-to-stone distance, anatomy of the excretory system, and renal anomalies, are also significant. The insertion of a routine double J stent before the procedure is not typically advised, nor is antibiotic prophylaxis required. For stones larger than 10 mm, alpha-blockers, in particular, tamsulosin, are helpful. Following ESWL, minor problems are possible but often respond favorably to therapeutic therapy. It is unclear how ESWL affects those with diabetes or hypertension.