Abstract Background: Shock wave lithotripsy (SWL) is a well-known technique used in the treatment of kidney stones since the early eighties. For successful SWL, accurate visualization of the shock waves is performed by ultrasound (US) or fluoroscope (FS) to fully focus the shock waves on the stone. Aim of Study: The aim of the study was to evaluate the outcome of ultrasonic localization in SWL treatment of pae-diatric renal stones on complications and treatment success. Patients and Methods: This study was conducted in Urology Department, Qena University Hospital from January 2021 to June 2022. This study was conducted on 50 children (2-16) years of age. Results: Regarding Stones free rate, our results revealed that SWL using ultrasonic localization is an effective primary treatment option for Paediatric Renal stones located in renal pelvis range from 10-20mm in size. Conclusion: The success rate of SWL using ultrasonic localization and complications. Therefore, we consider that ionizing radiation is not necessary in the pediatric age group. Not using ionizing radiation is an important advantage of ultrasonic focusing.