Objective: To assess the effectiveness of stepwise extracorporeal shock wave lithotripsy in the treatment of upper urinary stones in childhood. Patients and methods: Between August 1998 and August 2003, 31 patients were treated for renal or ureteric stones. All treatments were performed with Dornier Compact Delta lithotripter. The number of shock wave was limited to maximum 3000 shock waves/session. The voltage was started at 10 kV and increased stepwise to 12.75 kV. Stone clearance was assessed at 3 months. The stone free state was defined as the absence of stone fragments. Results: Total 31 stones (24 renal and 7 ureteral stones) were treated. The age of the patients was median 8 (min-max: 0.8-12) years. The length of the stones was median 1 (min-max: 0.5-1.5) cm for renal stones and median 0.5 (min-max: 0.5-1) cm for ureteral stones. As an auxiliary procedure, open pyelolithotomy was required for 1 patient. The overall stone free rates for renal and ureter stones were 79% and 100%, respectively. Post-treatment insignificant hematuria was observed in all cases. Conclusion: Stepwise shock wave lithotripsy was an effective procedure for the treatment of urinary calculi in childhood.