Background We investigated the effect of extracorporeal shock wave therapy (ESWT) on premature ejaculation (PE). Materials and Methods This patient-based prospective survey study. A total of 60 male patients aged 18 years and older who underwent perineal ESWT for chronic prostatitis (CP) and penile ESWT for erectile dysfunction (ED) were included in the study. The ages of the patients were recorded. The patients underwent ESWT for a total of 12 sessions (2 sessions per week for 6 weeks) without any anesthesia method. Intravaginal ejaculatory latency time (IELT), International Erectile Function Form, and PE Diagnostic Tool (PEDT) were evaluated before and 3 months after ESWT. PE symptoms and sexual function values of the patients were analyzed separately for the CP and ED groups before and 3 months after ESWT, and the groups were compared. RESULTS The average age of the CP group was 33.17±8.32 years and the ED group was 33.30±7.03 years. In the CP group, there was a significant improvement in erectile function, sexual and general satisfaction, and IELT and PEDT scores after ESWT treatment; In the ED group, there was a significant improvement in erectile function, orgasmic function, sexual desire, and sexual and general satisfaction scores after treatment. When the groups were compared, the treatment was found to be more effective in terms of sexual desire and orgasmic function in the penile ESWT group, whereas it was more effective in terms of IELT and PEDT scores in the perineal ESWT group. CONCLUSION Our study showed that; ESWT may be effective for the treatment of PE. It has been determined that this effect is more evident in perineal applications. Prospective, randomized, multicenter and high-participation studies are therefore needed.