Introduction: Although shockwave lithotripsy is introduced 3 decades ago still it is the first line surgical management to meet huge burden of urinary stones worldwide, despite availability of other newer modalities of effective treatment. For developing countries like India, it is very helpful and promising to meet demand of huge burden of patients with less number of urologist. Our aim was to study the efficacy and outcome of this procedure in our institute and how it is influencing the guidelines. Materials and methods: A prospective study over a period of two years was conducted in the department of urology in VIMSAR, Burla with patients 15-60 years age having single solitary stone of below 2cm size in the kidney and below 1 cm size for upper ureteric stone. Efficacy and outcome were calculated as rate of stone clearance, percentage of complications. Statistical analysis was performed. Results: A statistically significant 85.3% of patients get cleared and labelled stone free. Whereas 14.7% of patients having incomplete clearance switched over to other modality of treatment. A 20.6% of patients reported transient pain and other complication treated with appropriate medication which gradually subsided in follow-up. Conclusion: ESWL is the first line of management for renal and upper ureteric calculus in properly selected patients as it is non-invasive, economical, efficacious with minimal complication and can be done as day care procedure.