Background: Today urolithiasis is the third most common urological disease affecting elders with high recurrences rates. Extracorporeal shock waves lithotripsy (ESWL) became the treatment of choice for upper urinary tract stones without surgical intervention. The aim of this study: was to assess educational needs for elderly Patients undergoing extracorporeal shock waves lithotripsy in order to design an educational program as indicated by their knowledge. Descriptive research design: was used. Patients & methods: the study was carried out in Minia Al-Watany hospital. The sample was included 112 patients suffering from upper urinary tract stones undergoing ESWL procedure. Data was collected in a period of 6 months started from January to the end of June 2013. An interview questionnaire sheet consists of one tool was utilized divided into three parts, first part; included socio-demographic characteristics, second part; included past and present history, and third part; was to assess knowledge of elderly patients regarding disease and ESWL procedure. Results: the majority of patients were male, married, come from rural areas, and illiterate (66.1%, 79.5%, 50.9, and 61.6 % respectively), the mean of age was (65.46 ± 5.13). Results showed unsatisfactory total knowledge scores about urolithiasis, ESWL, and disease prevention among the studied sample. Conclusion: education for patients with urolithiasis undergoing ESWL is very necessary to achieve a satisfactory level of knowledge about the procedure, clearance of stone, and prevention of stone recurrence. Replication of this study on larger probability sample is highly recommended.