The 10-year experience of the urological clinic of M.F. Vladimirsky Research Clinical Institute included treatment of 219 patients (age 21-68 years, mean age 52.3 +/- 12.4; 59.2% females, 40.8% males) with urolithiasis which developed in the presence of anomalies of the kidneys and upper urinary tract. Uroliths were detected in the kidneys with homolateral (n = 51, 23.7%), lumbar (n = 49), iliac (n = 1), pelvic (n = 2) dystopia. Chest and heterolateral dystopia of the kidneys were not detected. Extracorporeal shock-wave lithotripsy (ESWL) was used in 38 (77.6%) patients, 11 (22.4%) patients were treated by other methods. A short-term effect of ESWL consisted in elimination of most of the concrement fragments while the residual fragments had no clinical symptoms being maximally 4-5 mm in size. It was noted in 23 of 38 (60.5%) patients. Six months after ESWL elimination of the concrement from lumbar-dystopic kidney occurred in 27 (71.05%) of 38 patients. Residual fragments 6-10 mm in size were registered in 26.35% patients, more than 10 mm--in 1 (2.6%). Complications after ESWL monotherapy of the concrements of the lumbar-dystopic kidney were seen in 26.3% (acute pyelonephritis 10.6%, stone track--7.9%, total hematuria--2.6%, acute prostatitis--2.6%, renal colic--2.6%). Mean treatment duration was 15.4 +/- 3.3 days. Thus, most effective therapy ofdystopic kidneys urolithiasis is ESWL the total efficacy of which reached 71.05%.