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In this study, a system of automatic gap-adjusted electrodes is developed for electrohydraulic shock wave generators that can be used both for extracorporeal shock wave lithotripsy (treatment of renal calculi) and for the extracorporeal shock wave therapy for musculo-skeletal disorders. This system is composed of three main components: (1) two electrodes and their bases; (2) servo motors and control software; (3) a high sensitivity CCD camera and image processing program. To verify system performance, in vitro fragmentation tests have been conducted using kidney stone phantoms. Results indicate that the efficiency of stone fragmentation using automatic gap adjustment can be increased up to 55.2%, which is twice more than without automatic gap adjustment (26.7%). This system can be applied to any commercial electrohydraulic extracorporeal shock wave lithotriptor or orthotriptor without difficulty.