One hundred fifteen patients with nonunions or delayed fracture healing were treated with high-energy shock waves. After shock wave treatment, immobilization of the fracture also was done. The followup was at least 3 months and as long as 4 years. In 87 patients (75.7%), one treatment with shock waves resulted in bony consolidation with a simultaneous decrease in symptoms. Besides negligible local reactions (swelling, hematomas, petechial hemorrhages), no complications were observed. The treatment was noninvasive, and personnel and technical requirements were not problematic. The authors concluded that the application of extracorporeal shock wave therapy should be the first choice of treatment for patients with nonunions and delayed bone fracture healing.