Between April 1990 and July 1994, Extracoporeal Shock Wave Lithotripsy (ESWL) was used to treat 1,132 patients with upper urinary tract calculi. Of those patients, 122 patients were not successful comprising (11%). Clinically non-successful case was defined those that were not believed likely to pass spontaneously, or were greater than 4mm in diameter at the 3 months after treatment. We reviewed non-successful 46 patients who had been followed for at least 3 months after treatment. The most common location was upper ureter (39%) in the non-successful cases, 41 of 46 patients were 10mm or greater in their stone size and the causes of non-successful ESWL were large stone burden or its composition in 30, impacted stone in 10 and poor localization in 6 cases. The treatment modalities of non-successful cases were open surgery in 37 cases and ureteroscopic stone removal in 9 cases. Considering these results, ESWL is thought to be easy, non-invasive and effective treatment in the properly selected upper urinary stone.