Background: Extracorporeal shock wave lithotripsy (ESWL) is one of the most important non-surgical procedures for treating urinary tract stones, so proper patient preparation for this procedure with applying progressive muscle relaxation (PMR) had a vital role in reducing pain and complications as well as improving the recovery rate. Aim: to evaluate the effect of progressive muscle relaxation and proper patients' preparation on selected complications post extracorporeal shock wave lithotripsy. Design: Quasi-experimental research design was used. The study was conducted in the urology outpatient clinic and shock wave lithotripsy unit at the University Hospital, Shebin El-kom district, Menoufia Governorate. A purposive sample of (232) patients undergoing extracorporeal shock wave lithotripsy were included in the study. Three instruments were used for data collection. Instrument 1; Structured interview questionnaire: It composed off our  parts; part one; patient's demographic data, part two: patient's medical data,  Part three: patients' knowledge about urolithiasis and extracorporeal shock wave lithotripsy, Part four: patient's urological assessment. Instrument 2: The visual analog pain scale. Instrument 3: Beck anxiety inventory scale. Results: There was statically significant increase regarding patients' level of knowledge that related to ESWL treatment, decreasing of pain, anxiety level and urological symptoms among the study group than the control group. Conclusion: The present study established that progressive muscle relaxation and proper patient's preparation had a positive effect in reducing pain, anxiety, and urological symptoms following post extracorporeal shock wave lithotripsy. Recommendations: Appropriate patient preparation prior shock wave lithotripsy at the unit is necessary to reduce complications risk, also Plans should be made for ongoing education for nurses so they can give patients the essential oral and written information regarding urolithiasis.