Shock-wave lithotripsy (SWL) has revolutionized the management of urolithiasis, and it is the preferred treatment for uncomplicated renal and proximal ureteral calculi. Since 1982, two years after its introduction, conflicting reports of early adverse effects have been published. However, to our knowledge the long-term medical effects associated with SWL are unknown. We reviewed the hypertensive effects associated with SWL for urolithiasis. A comprehensive MEDLINE (1980~December 2007) search of English-language medical journals was performed to identify articles on SWL and changes in blood pressure. This literature review summarizes studies to date. How SWL induces hypertension is disputed. Even now, we cannot conclusively determine whether SWL does or does not induce hypertension. More randomized control trials are needed to demonstrate the relationship between SWL and hypertension.