This paper presents results of implementation (1993) of extracorporeal shock wave lithotripsy (ESWL) in Perm region, in which nephrolithiasis is endemic. Results achieved with ESWL using two Dornier lithotripters in 6054 patients were analyzed in detail. 93% of the patients had complete and 6,2% partial stone destruction and clearance, therefore positive results were achieved in 99,2% patients. In only 0,8% of the patients ESWL did not result in stone destruction. ESWL complications were registered in 0,64% of patients and included: subcapsular kidney hematoma (0,03%), intense hematuria (0,15%), acute pyelonephritis (0,46%). Over the past 22 years since implementation of ESWL in Perm region with the use of 4 Dornier lithotripters the number of open surgeries for nephrolithiasis fell by 11 times (4% of all nephrolithiasis patients), nephrolithiasis mortality and length of treatment decreased by 5,4 and 4,1 times, respectively.