Objective To evaluate the effect of different body mass index（BMI）on external physical vibration lithecbole（EPVL）for the asymptomatic small renal calculi.Methods A retrospective analysis of 155 asymptomatic patients with small renal calculi admitted to Linyi central hospital from January 2019 to October 2020 was performed.Patients were divided into three groups according to BMI criteria, normal physique group（18.5 kg/m²≤BMI≤23.9 kg/m², 56 cases)，overweight physique group（24 kg/m²≤BMI≤27.9 kg/m²，65 cases），obesity physique group（BMI≥28 kg/m²，34 cases）. The effects of EPVL on daily stone excretion rate (SER) and stone excretion rate (SFR) at 1 and 2 weeks in patients with different BMI were analyzed. The satisfaction of different patients with active physical vibration stone removal was explored and analyze the related complications was analyzed.Results Patients with different BMI had high satisfaction with EPVL treatment (first experience of active stone discharge treatment, stone on the day of stone discharge, stone discharge treatment and expectation, and overall treatment), and there was no significant difference among the three groups (all P>0.05).Daily SER, 1 week SFR and 2 week SFR in the normal group were higher than those in the overweight and obesity groups, and the differences were statistically significant (all P<0.05). The incidence of complications such as skin allergy and vertigo was higher in the obesity group, and there was no statistical significance between the two groups (all P>0.05).Conclusions EPVL is a safe and effective auxiliary stone removal treatment, which has a high stone discharge rate and clearance rate. Different BMI can affect the stone removal effect of physical vibration in vitro, and non obese patients have better stone removal effect than obese patients.