Objective: To evaluate the effectiveness and safety of extracorporeal shock wave therapy in the treatment of ischemic heart disease. Subject and method: 20 multi-lesions patients with refractory angina were treated at the No.108 Military Central Hospital, treated by ESWT with the application of 100 shocks/spot at 0.09mJ/mm2 energy flux density for 3-6 spots each time, with three times per week at each series for three series at 1, 5, 9 weeks. The following parameters will be evaluated, including symptoms of angina and the exercise tolerance, breathlessness, echocardiography and myocardial perfusion imaging after 3 months. Result: The symptoms of angina decreased statistically significantly (amount of chest pain from 14.5 +/- 3.7 to 3.2 +/- 1.3, time of chest pain from 178.5 +/- 22.4 second to 20.8 +/- 13.6 second, using of nitroglycerin reduced from 8.7 +/- 2.4 pills to 1.0 +/- 0.5 pills, CCS angina class frpm 2.63 +/- 0.9 to 1.95 +/- 0.8. The exercise tolerance tests as six-minute walk test improved from 414 +/- 68.7 m to 526 +/- 89.5 m, breathlessness reduced from 85 percent to 50 percent and NYHA class scores (55 percent to 30 percent). Echocardiography and myocardial perfusion imaging improved remarkably after ESWT. ESWT is safe. No side effects and no rise of cardiac enzymes were observed with this therapy. Conclusion: Extracorporeal shock wave therapy (ESWT) in ischemic heart disease is effective and highly safe.