<p>Shock wave lithotripsy has been widely used in treating kidney stones due to its noninvasive procedure over the past decades. However, the treatment outcome is affected by multiple factors and the physical mechanism underlying the fluid-solid coupling between the lithotripter shock wave (LSW) and the solid stone is not sufficiently understood. Considering that a kidney stone usually displays an irregular shape, we perform numerical studies on the dynamic fluid-solid interaction between the LSW and an ellipsoidal solid stone. Our results suggest that the stress field during the dynamic shock loading condition on an ellipsoidal solid stone can be categorized into three types depending on the axis ratio, including Type I (flattened stone), Type II (circular stone) and Type III (elongated stone). For the flattened stones, geometrical focus mainly occurs near the anterior surface of the solid, while for the circular and elongated stones, the geometrical focus mainly occurs near the lateral surface. Quantitative results show that the peak tensile stress could reach up to 220 MPa inside the stone for COM stone, and the peak stress integral <i>S</i> reaches up to 3.9×10⁹ Pa²·s. Furthermore, our simulation results also suggest that the leaky Rayleigh wave generates strong tensile stress and stress integral near the solid boundary, particularly for Type III of the elongated stones. We believe that our findings provide new insights in shock wave lithotripsy and can also be valuable in other fields, such as cavitation erosion near solid materials.</p>