To explore the therapeutic feasibility, safety and efficacy of semi-sitting astride position for extracorporeal shock wave lithotripsy (SWL) of urethral calculi.A total of 7 male cases of urethral calculi from November 1997 to August 2013 were enrolled. Their age range was 24-52 years. There were anterior (n = 1) and posterior (n = 6) urethral calculi. The diameter range of stone was 0.5 cm×0.5 cm to 1.0 cm×2.0 cm. BH-VG twin-pulse low-energy SWL was employed with a semi-sitting astride position. The average frequency was 2 500 (1 800-3 500) times. And the treatment voltage was 3-8 kV.Both stone fragmentation rate and stone-free rate 1 hour post-SWL was 100%.No severe complications occurred.Semi-sitting astride position SWL is simple, safe, effective and feasible for posterior urethral calculi.