The goal of kidney stone treatment among the elderly patients is to achieve maximal stone clearance with minimal morbidity to the patient. Modern technological advances in the design of extracorporeal shock wave lithotripsy (ESWL) became the first treatment choice for most upper urinary tract stones in elderly without surgical intervention. ESWL have several advantages for elderly; it is done as an outpatient procedure, no need for anesthesia, no wound, and less complications rates. It is an effective procedure for managing 85-90% of upper urinary tract stones in elders safely (Chandhoke, 2014).