Objective To study the pressure field with the single-pulse and the dual-pulse for extracorporeal shock wave lithotripsy (ESWL) by numerical simulation, and to compare and analyze the results. Methods2D axisymmetric Euler equations and hybrid grids improved CE/SE numerical scheme were employed to simulate the pressure field of underwater shock wave in ESWL. Results The CE/SE shock wave dynamics method could successfully track the transmission of shock wave front, and the simulation solution could preferably reveal the focusing properties near the focus of ESWL: the pressure of dual-pulse was about the twice that of the single-pulse near the focus, and the higher lithotriptic efficiency could be achieved when the dual-pulse was much closer to the focus than the single pulse. A negative pressure with high absolute value was observed after the positive pressure occurred near the focus. ConclusionsThe adoption of electro hydraulic lithotripter could effectively improve the efficiency of stone comminution and the cavitation of shock wave focus was unavoidable, which provided a reliable numerical simulation result for the design and application of ESWL lithotripter in clinic.