Low-intensity extracorporeal shock wave therapy (LI-ESWT) as a representative of physical medicine has the application potentials in multiple diseases and orientations. Recent studies have found that LI-ESWT can also be used to enroll and activate endogenous stem cells. Activating the spermatogonial stem cells with LI-ESWT may bring a new breakthrough to the treatment of the patients with idiopathic non-obstructive azoospermia and latrogenic obstructive azoospermia. This article reviews the application and prospect of LI-ESWT in activating the spermatogonial stem cells for azoospermia.