PURPOSE: To compare the clinical results of High intensity laser therapy (HILT) versus Extracorporeal shock wave therapy (ESWT) in the lateral epicondylitis. MATERIALS AND METHODS: Fifty patients who suffer from lateral epicondylitis for more than six month duration were randomly assigned two treatment groups. Group 1 (n=25) was treated with HILT using a HIRO 3.0 laser(ASA srl, Arcugnano, Italy) and total energy was administered approximately 1200J following a standard protocol for each session; Group 2 (n=25) recieved with ESWT treatment using an EvoTron(Switech Medical AG, Kreuzlingen, Switzerland) for a total of 1000 shocks for each session. The patients were evaluated by assessment of pain using visual analog scale (VAS) and simple elbow test (SET). Comparision of overall clinical outcomes were evaluated by Roles and Maudsley score at 9 months. RESULTS: Average VAS and SET scores were significantly improved in two groups, also achieved significant improvement of symptoms at 9 months follow up according to Roles and Maudesley scores(P<0.05). The success rate in the HILT group was 76 % and in the ESWT group was 72 %. CONCLUSIONS: This study suggests that HILT could be considered as effective and noninvasive treatment modality for lateral epicondylitis.