The safety and efficacy of extracorporeal shock wave lithotripsy in 5 dogs with nephrolithiasis and ureterolithiasis was assessed. Three dogs had bilateral nephrolithiasis, 1 had bilateral nephrolithiasis and unilateral ureterolithiasis, and 1 had unilateral nephrolithiasis and unilateral ureterolithiasis. A first-generation lithotriptor was used for all treatments. None of the dogs developed clinically important complications during or after treatment, except for 1 dog treated for bilateral nephrolithiasis that developed transient ureterolithiasis. Renal function was unchanged in all dogs following treatment. Clinical signs resolved in all dogs. Extracorporeal shock wave lithotripsy appears to be a safe and effective means of treating nephrolithiasis and ureterolithiasis in dogs and appears to cause less renal parenchymal damage and renal function loss than does nephrotomy.