Objective: To test whether extracorporal shock wave therapy (ESWT) has an effect in the treatment of Peyronie’s disease.Methods: 22 patients with Peyronie’s disease and previous unsuccessful oral drug therapy were treated with ESWT in a prospective design with a follow–up of at least 3 months; 23 age–matched patients without previous therapy received oral placebo drug for 6 months daily as control. The standard follow–up included palpation, ultrasound, autophotography and evaluation of symptomatology based on a symptom score. The shock waves were applied under ultrasound guidance using the ‘Storz Minilith SL1’ lithotripter.Results: The results show a significant decrease in penile curvature in the patients treated with ESWT. Concerning the decrease in pain, subjective improvement and improvement in the quality of sexual intercourse, there was no significant difference to the case–control group. The inhomogeneity of the 2 groups may influence these results due to the questionable varying natural history.Conclusions: A prospective, controlled multicenter study with standardized parameters (concerning technique and patients) is urgently required to test the effect of ESWT.