Background: Extracorporeal shock wave therapy is considered effective, safe, with little to no complications for treatment in medicine and physiotherapy. Its effect is not only an answer of the tissue to mechanical stimulus, but also a cascade of biological reactions of the cell through transduction. The purpose is finding scientific evidence of biochemical effects of extracorporeal shock waves. Methods: The chosen method is a literature review. The literature was searched in Cochrane, ScienceDirect and PubMed in June 2017. Results: Eight studies fit the inclusion and exclusion criteria and they researched the effect of extracorporeal shock waves on osteoblasts, stem cells, macrophages, skin tissue and tenocytes. Conclusions: The mechanism behind the effects of extracorporeal shock wave therapy is mechanotransduction, which transforms mechanical signal into an electrochemical signal in the target issue. The correct dosage of shockwaves has positive outcomes, but the wrong choice of parameters can lead to negative outcomes. However, long term outcomes and in vivo effects on healthy and pathological tissues should be further investigated.