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Shock waves are three-dimensional pressure pules of microsecond duration with a peak pressure of 35–120 MPa. Technological advancements of medical shockwaves made over recent years have broadened the spectrum of its clinical application from being just purely a destructive force, into a treatment modality that engenders a myriad of genesis effects associated with tissue regeneration. Currently used focused shock wave systems differ in their design and depend on whether the shock waves are generated by electrohydraulic, electromagnetic or piezoelectric mechanisms. Observation of its biochemical and biocellular responses have noted progenesis effects such as angiogenesis, osteogenesis, and tendogenesis. ESWT has been successfully applied to the treatment of tendinopathy of the shoulder, ellow, patella, Achilles, and the calcaneus, and also union of the long bone. Recently, ESWT utility was expanded to the cardiology, andrology, diabetiec neuropathy, uterine fibrosis, etc. to improve the life quality while reducing the burden of healthcare.