Introduction: Urolithiasis is one of the most common clinical conditions in the history of medicine. Treatment methods include conservative, surgical treatment and extracorporeal shock wave lithotripsy (ESWL). Several stone characteristics are known to affect outcome of ESWL such as fragility, Hounsfield unit, size, site, composition etc. No study has been done till now regarding the efficacy and safety of ESWL in eastern Indian patients. Objectives: To assess the efficacy and safety of ESWL in the management of patients with renal and ureteral stones. Methods: 112 outpatients were treated with ESWL. Stone size, location, total number of shockwaves, stone-free rate, complications and adjunctive interventions were investigated. Chi-Square and Logistic Regression analyses were used, with p<0.05 set as the level of significance. Result & Conclusion: The authors found significant association between the size and number of stones with fragmentation status. The authors found that stones of more than 11mm size are more resistant to ESWL. Authors found statistically significant association between the number of ESWL sessions with fragmentation status. However, more than 3 sessions also did not help much. It was also found that complications were more in partially fragmented group and more adjunctive procedures were required in partially fragmented group. The authors also noticed that the stented or non stented status and total number of shocks were not significantly associated with the fragmentation status of stones.