BACKGROUND ESWL is suitable for stones smaller than 2 cm situated in upper and middle calyx. The routine insertion of DJ stents during ESWL of renal calculi is controversial. Some studies support the role of DJ stents in facilitating stone passage and preventing renal colic whereas other reports claim that stent causes significant lower urinary tract symptoms, hematuria, urinary tract infection and can even lower the stone-free rate. METHODS This is a prospective study conducted among 81 patients each in stented and non stented group who underwent ESWL for renal calculus. The primary outcome measured was stone fragmentation .The secondary outcomes measured were renal colic, urinary tract infection, steinstrasse and stent related LUTS. RESULTS Stone fragmentation rates in stented and non-stented groups were 91.4% and 86.4% respectively (p-value > 0.05). Ureteric colic in the stented group was only 14.8% but 45.7% in the non-stented group had ureteric colic (p-value <0.05). Lower urinary tract symptoms were significantly higher in the stented group (44.4%) when compared to the non-stented group (13.6%) and the p-value was < 0.05. The occurrence of steinstrasse and urinary tract infection were similar in both groups. CONCLUSIONS Double J stents neither improve the stone fragmentation nor lead to enhanced passage of stone fragments in patients undergoing ESWL. DJ stent effectively prevents ureteric colic which occurs due to the passage of fragments down the ureter. Patients with DJ stent have statistically significant lower urinary tract symptoms. The occurrence of UTI and Steinstrasse was seen in both groups and was unrelated to the presence of DJ stent.