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Background and aims: Extra Corporeal Shockwave Lithotripsy (ESWL) is the treatment of choice for urinary lithiasis. Majority of patients experienced pain during ESWL. Acupuncture is a traditional method of treatment in which relieving pain is a feature. This study aimed to evaluate its therapeutic effect on diminishing the pain during ESWL. Method: This clinical trial study performed on 100 patients infected to Urinary lithiasis who were candidate to ESWL operation. They were visited by Acupuncture specialist before starting ESWL and randomly divided into two groups of True Acupuncture and Sham acupuncture. In the first group, acupuncture was carried out in 4 special points of acupuncture for 30 minutes and in the second group acupuncture was ineffectively applied to the same points for 30 minutes. Then ESWL was begun and the intensity of pain compared in two groups using the numeric 0-10 VAS scale. Results: Findings in this study showed that the pain rate mean was significantly lower in true acupuncture group (2.74 ±0.92) than Sham group (4.34 ±0.87). Also, stone size in both groups was significantly related to pain intensity during ESWL (P<0.01). As the stone is bigger, the pain will be more. Age and sex did not have any significant effect on pain. Conclusion: Applying acupuncture in patients, who have been under ESWL, reduces the pain during ESWL. [ABSTRACT FROM AUTHOR]