We experienced a case of peripelvic extravasation after extracorporeal shock wave lithotripsy (ESWL) treatment. A 62-year-old man was admitted to our hospital with a complaint of macroscopic hematuria. The patient was diagnosed as having a radiolucent stone in the right kidney and ESWL treatment was performed to focus the stone by using drip infusion pyelography (DIP) under epidural anesthesia. The patient had right flank pain two weeks after ESWL treatment. DIP and computerized tomography (CT) showed peripelvic extravasation of contrast medium. Right pain improved after a double-J catheter was placed for decreasing intra-pelvic pressure. As a result, the disappearance of peripelvic extravasation was recognized by DIP and CT. We reviewed four cases of peripelvic extravasation after ESWL treatment including our case in the Japanese literatures and discussed the cause of peripelvic extravasation after ESWL treatment.