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Objective To evaluate the effectiveness of shock wave lithortripsy (SWL) for treating patients with calculus after failure of endoscopic lithortripsy. Methods From Feb. 2006 to Mar. 2007, 60 patients presented to our department with the upper urinary tract stones. Thirty-seven patients were renal stones and twenty-three were ureteral stones. All patients with average stone burden of 1.5 cm were treated using a Dornier Compact S lithotripter. The total number of shock waves varied from 1 600 to 3 000 and the energy levels ranged from 1 to 6 units. Results For 37 renal stones, the fragmentation was 75. 67% (28 cases) after one SWL session, 10.81% (4 cases) after2 SWL sessions, 5. 40% (2 cases) after 3 SWL sessions, and 2. 70% (1 case) after 4 SWL sessions. Two patients (5. 40% ) failed and changed to open surgery. For 23 ureter calculus, the fragmentation was 82.60% (19 cases) afler one SWL session and17. 40% (4 cases) after 2 SWL sessions. Conclusion SWL is an effective and reliable treatment for patients with calculus after failure of endoscopic lithortripsy. However, it is very important for doctor to choose appropriate therapy. SWL is a remedy.