Today, most stones can be removed by minimally invasive means. Extracorporeal Shock Wave Lithotripsy (ESWL) is the preferred form of treatment for symptomatic upper ureteral and renal calculi less than 2 cm a diameter. The short and long term complications of ESWL are underestimated. Thus, ESWL may cause renal trauma and such trauma may induce later hypertension. In this retrospective study, we reviewed the frequency of deleterious effects of ESWL in 45 patients who had undergone ESWL from January 1988 to September 1989. Short-term complications were macroscopic hematuria (15%), lumbar pain (11%) and peri- or intrarenal hematomas (4.4%). Two years later CT scan was performed in 20 patients. It was normal in 7 (35%). In others, it shown a recurrence of stone in 8 (40%) and a focal scarring in 5 (25%). Only 1 out of 43 patients had developed hypertension.