Basing on the area of pressure ulcer analyses and studies the correlation between the impact dose of extracorporeal shockwave and the curative effect of stage IV pressure ulcer and its safety was studied. Seventeen patients were randomized into two groups according to the random number table method, including 8 cases in traditional group and 9 cases in modified group. The pressure ulcers in both groups were treated by conventional radical debridement and alginate dressing. The two groups were treated every other day, three times a week, continuous for 12 weeks, at same time the two groups were treated with extracorporeal shockwave. The treatment parameters of traditional group were set at 2.0 ∼ 3.0 bar, 4 ∼ 5 Hz, the total number of pulses was (200 ∼ 300) + 100/cm 2 times, once a week,continuous for 12 weeks. The treatment parameters of the modified group were set at 2.0 ∼ 3.0 bar, 4 ∼ 5 Hz, the total number of pulses was 2000 times, once a week, continuous for 12 weeks. The degree of pressure ulcer healing was evaluated before treatment, 6,12 weeks after treatment by PUSH. After 6 weeks of treatment, the areas of pressure ulcer, exudation, wound tissue and total score in the modified group were better than the traditional group, and the difference was statistically significant ( P < 0.05). After 12 weeks, the pressure ulcer area, exudation, wound tissue and total score in the modified group were better than the traditional group, the difference was statistically significant ( P < 0.01). After 12 weeks, the healing rate in the modified group was 66.67%, which was significantly better than traditional group which was 25.00%. Based on pressure sores area to determine the impact of extracorporeal shockwave dose, can significantly improve the curative efficacy of extracorporeal shockwave in the treatment of stage IV pressure ulcers.