Chronic venous ulcers are one of the most common medical problems today. The treatment has always been challenging and over the years many conservative and surgical alternatives have been proposed. During the past three decades, extracorporeal shock wave therapy (ESWT) has been introduced in several medical specialties. According to the clinical findings, the ESWT appears to significantly improve the healing process of chronic wounds, increasing the release of endogenous angiogenic factor from endothelial cells and fibroblasts, consequently fastening the healing process of chronic wounds. The present report describes the application of ESWT for the treatment of chronic venous ulcers in the lower limbs and compared the results with those obtained by conventional treatment on the contralateral leg.