Extracorporeal shock wave lithotripsy (ESWL) is the most required urinary stone therapy in our country and in the rest of the world. In a way it has replaced the alternative treatments (open surgery, percutaneous nephrolithectomy, ureteroscopy). Nevertheless these therapeutic approaches have still its own indications. Although there is no a definitive agreement, it should be desirable a world-wide consensus where each therapy will have a exactly defined land with all potential of each management improved. We review ESWL technical aspects, its literature-based most accepted indications, adverse bioeffects and last, future improvements are considered.