BACKGROUND: Greater Trochanteric Pain Syndrome (GTPS) poses significant challenges in clinical management due to its multifactorial etiology and limited treatment options. Extracorporeal Shockwave Therapy (ESWT) has emerged as a promising intervention in the recent past. This review aimed to evaluate the clinical efficacy of ESWT in managing GTPS symptoms. METHODS: Systematic searches were conducted on PubMed, Scopus, PEDro, and Web of Science. For quality assessment we utilized the PEDro scale, while Cochrane Risk-of-bias tool version 2 (RoB 2) helped evaluate the risk of bias. Meta-analysis was performed on six out of seven included studies. The primary outcome studied was pain intensity, and secondary outcome was lower extremity function. The analysis was done for r-ESWT and f-ESWT separately, wherever applicable. RESULTS: Seven trials with 714 participants were analyzed; six included in the meta-analysis. The meta-analysis of trials where f-ESWT was given showed that f-ESWT was significantly more effective than control/alternative treatments (SMD -1.96; 95% CI -3.22 to -0.71; Z 3.06, p = 0.002) in reducing pain, with significant results obtained in the medium, but not in the long term. f-ESWT was found to be more effective in improving lower extremity function in GTPS (SMD 0.61; 95% CI 0.41 to 0.81; Z 6.02 p < 0.00001). r-ESWT did not offer any significant benefit for reducing pain intensity over control/alternative treatments in either short, medium, or long-term follow-ups (SMD -0.03; 95% CI -0.41 to 0.35; Z 0.16, p = 0.87). CONCLUSIONS: f-ESWT can improve pain intensity and lower extremity function more significantly when compared to control/alternative treatment groups. Study registration. The procedure used for analysis and the pre-determined eligibility criteria was registered at the International Prospective Register of Systematic Reviews (PROSPERO) on March 04, 2024, registration ID: CRD42024515778.

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