Extracorporeal shock wave lithotripsy (ESWL) has been widely used for the management of urolithiasis. A fiver subcapsular hematoma is an extremely are complication of ESWL. We report a 51-year-old male pafenl who received ESWL for a right renal stone and experienced this complication. The pallent was sent to the emergency room with the chief complaint of right upper abdominal and flank pain 3 days after the ESWL. Anemia was noted at the same time. Computed tomography revealed a subcapsular hematoma of the liver. Rupture of the hematoma was noted with signs of hypovolemic shock on the third day of admission. An emergent exploratory laparotomy with hepatorrhaphy was performed. There was no further bleeding after the operation. The literatures on this complication is reviewed. and possible causes of the condition are discussed.