This comprehensive review updates the advances in extracorporeal lithotripsy , including improvements in external shockwave lithotripsy and innovations in ultrasound based lithotripsy, such as burst wave lithotripsy, ultrasonic propulsion, and histotripsy . Advances in endoscopic technology and training have changed the surgical approach to nephrolithiasis ; however, improvements and innovations in extracorporeal lithotripsy maintain its status as an excellent option in appropriately selected patients.