This systematic review and meta-analysis included twenty-two randomized controlled trials involving patients with upper and lower limb tendinopathies. The comparisons were between Extracorporeal Shockwave Therapy (ESWT) and other treatment options, considering both calcific and non-calcific types of tendinitis. Pooled outcomes of interest included pain reduction and Disabilities of the Arm, Shoulder, and Hand (DASH) scores. The meta-analysis demonstrated no significant differences in pain reduction or DASH scores between the ESWT and comparison groups at various time points. ESWT was specifically noted to be effective for lower limb and calcific tendinitis but showed no superiority over other treatments for upper limb and non-calcific tendinopathies. The findings suggest that while ESWT is effective for certain tendinopathies, it does not outperform other treatments across all considered conditions.