Background:The spastic cerebral palsy isconsidered the most common of cerebral palsy types. Spasticity of upper limbs is major problem in children that affected on hand function during grasping and through using assistive devices as walker and canes. Shock wave treatment on spastic muscles of upper limbs in stroke patients performed a significant decrease in muscle tone.The aim of current study was to determine the impact of extracorporeal shock wave therapy (ESWT) on spastic muscle of hand in children with spastic cerebral palsy.Methods:Thirty twohemiplegic spastic cerebral palsy patients from both sexes were recruited in this study.The children were divided randomly into two groups equal in number; GroupӀ(control)consisted of 16 children(7 boys and 9 girls) with mean±standard deviation age of 6.68±2.63years received exercises program only (3sessions/week for two months, GroupӀӀ(experimental)included (10 boys and 6 girls)with mean±standard deviation age of 6.37±1.44 years received the same exercises program in addition to sessions by extracorporeal shock wave therapy(BTL-6000WT) with energy flux(0.003mJ/mm²),frequency (10Hz)and (one session/week) for 8 weeks .The two groups were evaluated before and after therapy by Modified Ashworth Scale (MAS) and Modified House function Classification (MHC).Results:The results showed a statistically significant improvement in spasticity and hand function post treatment.Conclusion:We concluded that the ESWT is effective in decreasingspasticity(muscle tone) of upper extremities and enhancinghand function for patients with spastic cerebral palsyto help those children become independent and participate in different daily activities as grasping of walker or canes.