Objective To investigate the efficacy and related of Radial Extracorporeal Shock Wave Therapy (rESWT) for Long-Bone Nonunion. Methods: We analyzed retrospectively 54 patients(54 bones) with long bone nonunion who underwent the treatment of rESW between September 2014 and June 2019 in The Sixth People’s Hospital of Huizhou. There are 13 femora, 22 tibia, 2 fibula, 6 humerus, 4 ulna and 7 radia. rESW were performed without anesthesia, four rESW sessions were performed at one-week intervals. To observed the VAS score, complications, success rate and risk factors of rESW with a minimum follow up of 12 months. Results: VAS score after treatment was lower than before treatment, there was statistical significance (P<0.05). After 3 months, 6 months and 12 months after rESW treatment, the success rates were 64.81%, 72.22% and 74.07%, respectively. Three patients developed mild swelling pain and discomfort at the fracture point, 1 patient developed skin edema, 2 patients developed subcutaneous congestion, and no long-term complications were observed. Chi-square test showed that the success rate of hypertrophic nonunion was higher than atrophy, there was statistical significance (P<0.05).Logistic regression analysis showed that there were statistical significance in the interval time, operation times and the fracture gap. The age comparison was not statistically significant. Conclusions: As a noninvasive treatment ,rESW is effective and safe for the long bone nonunion, and without local anesthesia. The category of delayed union and nonunion, the interval time, the previous operation times and the fracture gap are the reasons for the success of rESW, but age is not.