This study help choosing an appropriate therapy for stones smaller than 1.5 cm represents a controversial area in urology. It is a non-randomized clinical trial study conducted by selected patients categorized non-randomly into two groups (25 patients treated with extracorporeal shock wave lithotripsy followed by percussion, diuresis and inversion therapy) and (25 patients treated with ESWL alone). The mean stone size after 2nd session of treatment with ESWL followed by percussion, diuresis and inversion therapy was significantly lower than mean size of stones for patients after 2nd session of ESWL (p=0.01). After 3rd session, mean stone size of patients treated with ESWL followed by percussion, diuresis and inversion therapy was significantly lower than mean size of stones for patients treated with ESWL (p=0.01). There was a significant association between disappearance of lower pole stones and patients treated with ESWL followed by percussion, diuresis and inversion therapy (p=0.01). The ESWL with percussion, diuresis and inversion therapy is more effective in clearance of lower kidney pole stones with size of 15 mm than conventional ESWL.