Extracorporeal Shock wave lithotripsy (ESWL)is anestablishedmodality for treating renalcalculiinadults.TheefficacyofSWLfor pediatric calculi hasbeenunderscrutinybecauseoftheunknown longterm effectsof shockwaveson developing renalparenchyma.Thepresent study aims atassessingtheefficacyofSWLforpediatricrenalcalculiandalsoincludesrenalunitswithcongenitalanomaliesasmalrotationandhorseshoekidney.The study wasdonebetweenJan1998andJune2006in19childrenandtreated20renal calculi.   Completefragmentationoccurredin18outof19cases(94.75%).12patients(63.15%)required1sittingwhereas6(33.33%)required2sittings.Inthegroupstudied2casesof malrotation and1with horseshoekidney were successfully treated.WeconcludethatESWL is an excellentmodalityfortreatingpediatric renalcalculiwithminimum morbidity.Itcanbe easilydoneundersedoanalgesiainchildrenwithouttheneedofgeneral anesthesia.