Extracorporeal shock-wave lithotripsy remains a widely utilized treatment modality for renal and some ureteric calculi. The treatment is generally considered very safe. However, minor complications occur in a significant number of patients. Serious complications, causing ongoing morbidity or mortality, are rare, affecting less than 1% of patients. A review of the literature on the adverse effects of the treatment, with an emphasis on those which might present to ED is presented.