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Between November 1988 and January 1992, 19,962 renal and ureteral calculi were treated in the United States using 18 different mobile and 2 fixed base Lithostar lithotriptors. Lithotripsy was performed on 11,516 renal and 8,446 ureteral calculi by 750 urologists using the same technique. The success rate (asymptomatic with stone fragments of 4 mm. or less) for renal stones was 87.9%, the stone-free rate was 68.9% and the retreatment rate was 16.5%. Auxiliary procedures were performed in 32.2% of the renal calculi. The success rate for ureteral calculi was 89.5%, the stone-free rate was 83.5% and the retreatment rate was 10.7%. Auxiliary procedures were performed in 25.5% of the ureteral calculi. The overall success rate was 88.4% stone-free rate 75.5%, retreatment rate 14.0% and auxiliary procedure rate 29.4%. Anesthesia personnel were used in 1.9% of the cases. Low energy extracorporeal shock wave lithotripsy was found to be safe and effective.