The aim of this study was to investigate the effect of extracorporeal shock wave lithotripsy (ESWL) on kidney oxidative stress and trace element levels of adult rats. Twelve male Wistar albino rats were divided equally into two groups. First group was used as control. The right-side kidneys of animals in second group were treated with 2,000 18-kV shock waves under anesthesia. Localization of the right kidney was achieved following contrast medium injection through a tail vein under flouroscopy control. The animals were sacrificed 72 h after the ESWL treatment, and the kidneys were taken. Malondialdehyde level was higher in the ESWL group than in the control. Reduced glutathione levels, superoxide dismutase, and glutathione peroxidase activities were lower in the ESWL group than those of the control. Fe, Cu, Pb, Mn, Cd, and Ni levels were lower in the ESWL group than in the control, although Mg level was higher in the ESWL group than in the control. In conclusion, the result of the present study indicated that ESWL treatment produced oxidative stress in the kidney and caused impairments on the antioxidant and trace element levels in the kidneys of rats.