Over the past 20 years, development of minimally invasive therapies has led to the use of extracorporeal shock wave lithotripsy (ESWL) to treat salivary stones. The two main energy sources are piezoelectric and electromagnetic extracorporeal lithotripsy. Both have the aim of fragmenting the stones. ESWL is considered the treatment of choice for all parotid calculi and submandibular perihilar or intraparenchymal stones of less than 7 mm. Continuous ultrasonographic monitoring during the procedure reduces the number of untoward effects. The main limitations are the need for multiple sessions and residual stone fragments inside the duct system.