In recent years, extracorporeal shock wave therapy (ESWT) and radial shock wave therapy (RSWT) have been introduced as safe and effective treatment options for cellulite. A shock wave is an acoustic pressure wave that is produced in any elastic medium such as air, water, or even a solid substance. Shock waves differ from sound waves in that the wave front, where compression takes place, is a region of sudden change in stress and density. Therapeutic shock waves are characterized by a high positive peak pressure (usually between 10 and 100 MPa), a fast initial rise in pressure (less than 1 µs), a diffraction-induced tensile wave (up to -10 MPa) following the positive pressure amplitude, and a short life cycle of approximately 10-20 µs. Extracorporeal shock wave lithotripsy (ESWL) is widely used for stone management in urology. ESWT and RSWT are byproducts of lithotriptor technology. Since the late 1980's they have been introduced into the treatment for various diseases of the musculoskeletal system such as plantar fasciopathy, Achilles tendinopathy, medial tibial stress syndrome, greater trochanteric pain syndrome, lateral and medial epicondylitis, and calcifying tendonitis of the shoulder. Shock waves have both a direct and indirect effect on treated tissues. The direct effect is the result of the energy of the shock wave being transferred to the targeted tissues. The indirect effect is the result of the creation of cavitation bubbles in the treated tissue. It has been hypothesized that both the direct and indirect effects produce a biological response in the treated tissues. ESWT devices share two technical key characteristics of ESWL devices used for stone management, namely the electrohydraulic, electromagnetic, or piezoelectric generation of pressure waves and the generation of focused or so-called defocused pressure waves. Radial shock waves are generated ballistically, i.e., by accelerating a bullet that strikes an applicator, transforming the kinetic energy of the bullet into a radially expanding pressure wave.