CREST syndrome is a variant of systemic sclerosis, which affects a relatively small number of patients. CREST (also called limited cutaneous scleroderma) has a more favorable prognosis than the diffuse form of scleroderma. However, cutaneous calcinosis, which occurs during the disease course, is always difficult to manage. There are very few satisfactory medical and surgical therapies for cutaneous calcinosis in connective tissue disorders. For these reasons, we tried a new therapeutic approach, extracorporeal shock wave lithotripsy (ESWL). ESWL, a minimally invasive treatment, plays a major role in the treatment of urolithiasis. It has a high success rate, and the spectrum and incidence of treatment-related morbidity are low. This technique has not been previously reported for the treatment of cutaneous calcinosis in scleroderma.