The kidney is a paired parenchymal organ, located retroperitoneally along the spine. The kidney plays an extremely important role in the human body in homeostasis through the regulation of water, electrolyte turnover, excretion of by-products of metabolism, maintenance of acid-base status and many other functions. Nephrolithiasis is one of the most common urological problems which, if not adequately treated, can lead to kidney damage and long-term consequences. There are currently several methods of treating nephrolithiasis and one of them is ESWL. ESWL is the method that is preferred for smaller concretions up to 20 mm in size, located on the upper half of the kidney, mesorenal and in the renal pelvis, because they are the most suitable for removal and in such patients this method has the highest treatment success rate. ESWL, like any procedure, has its own indications, contraindications and complications, and it is important to use this method in patients in whom it will bring the greatest benefit and the lowest risk of complications. The main working principle of ESWL is the use of acoustic waves which aim is to break the stone into smaller parts so that it can then be excreted through the urinary tract. This method is minimally invasive and uses a device called a lithotriptor which causes the disintegration of the stone and imaging diagnostic methods to determine the position of the stone and the success of its treatment. If the calculus is larger or it has other characteristics that are not suitable for ESWL treatment, other treatment methods such as PCNL or RIRS are considered. Each patient should be approached individually and the most appropriate method of treatment should be selected. It is important to emphasize that we should work more on patient education and primary prevention of nephrolithiasis, especially in those who already have predispositions for their development.