Most of the urinary calculi that extracorporeal shock wave lithotripsy (ESWL) has been failed or contraindicated are treated with endourological procedures. Electrohydraulic, laser, ultrasonic or pneumatic devices are used for in situ stone fragmentation during the percutaneous nephrolithotripsy (PCNL), ureteroscopic lithotripsy (URS) or cystolithotripsy procedures. The aim of this study is to evaluate the efficacy of pneumatic lithotripsy in the different portion of the urinary tract. The records of 85 patients who treated by endourological procedures were reviewed retrospectively. 51 URS were performed in 47 patients (bilateral for three patients and two séances for one) and 23 PCNL in 21 patients (bilateral for two patients) and 17 cystolithotripsy in 17 patients. Pneumatic lithotripsy device (VibrolithTM, Elmed, Turkey) was used in all procedures. The fragmentation and clearance of all reached calculi was considered as a success. 44 of 47 patients in URS group have become stone-free (%93.6). Two patients who could not treated successfully by URS managed by ESWL and both become stone-free. All reached calculi are fragmented by pneumatic lithotripter during PCNL procedure (%100). Our stone-free rate for PCNL was %75 due to the unreached stones or incomplete procedure because of the bleeding. ESWL was added for these patients and 94% of them become stone-free 3 months later. 15 patients with bladder stone and 2 patients with posterior urethral stone were successfully fragmented (%100). The results of 48 patients stone analysis were 16 calcium oxalate, 12 mixt type, 11 magnesium ammonium phosphate, 2 uric acid and 1 cystine stone. Pneumatic lithotripsy (PL) is an effective, safe, easy applicable and cost-effective procedure for PCNL, URS and cystolithotripsy. PL can achieve successful fragmentation in all stone composition. In addition, extraction of pieces of calculi might more easy and quick than the other lithotripsy systems because the stones separated to bigger pieces by pneumatic lithotripter.