Introduction: Cellulite affects 95% of women and can lead to negative consequences. Objective: To demonstrate the efficacy and safety of acoustic wave therapy (AWT®) using extracorporeal pulse activation technology (EPAT®) to manage cellulite. Methods: Twenty-five women were included in the study and treated with AWT®. Six AWT® treatment sessions were performed over the course of 4 weeks. Three thousand pulses were applied to an area measuring approximately 10 × 15 cm on the thigh. The treatment was performed using the D-ACTOR® 200 by STORZ MEDICAL AG (Tägerwilen, Switzerland). Follow-up visits were performed 1 week and 12 weeks after treatment. Changes in the skin structure were evaluated using the DermaTOP System (Eotech, Paris, France). Skin elasticity measurements were performed using the DermaLab Device (Cortex Technology, Hadsund, Denmark). Results: The difference between treated and untreated legs was statistically significant with regard to depressions, elevations, roughness and elasticity after the first follow-up visit. Conclusion: The study showed that the AWT/EPAT treatment using the D-ACTOR 200 appears to be a safe and effective treatment alternative for the temporary improvement in the appearance of cellulite.