Objective: The study explores how LS-DYNA software can be used to simulate the distribution and propagation of radial extracorporeal shockwave therapy (rESWT) in biological tissues. Through analyzing pressure waves, researcher aim to improve the treatment efficacy, the treatment dose and contribute to the general rESWT understanding. Methods: Researchers construct a three-dimensional tissue model based on previous studies and add a simulated ballistic shock wave generator. Simulation parameters such as tissue properties and shock wave properties are acquired from experiments and clinical settings. Simulations are performed with the use of explicit finite element analysis techniques, and researchers can examine details such as wave structure, amplitude distribution, and remote attenuation. Result: The study utilized LS-DYNA software to simulate the distribution and propagation of radial extracorporeal shockwave therapy (rESWT) in biological tissues. The simulation results showed that the positive peak pressure amplitude of pressure waves is significantly reduced when transmitted from skin to adipose tissue (by about 40.71%) and from skin to muscle (by up to 89.97%). Additionally, the energy flux density (EFD) of pressure waves is reduced by 42.96% when propagating through the skin, and only about 23.46% of EFD was transmitted from the skin to the interface between adipose and muscle. Conclusion: The study includes the successful use of LS-DYNA software to simulate the distribution and propagation of radial extracorporeal shockwave therapy (rESWT) in biological tissues. The findings indicate significant reductions in positive peak pressure amplitude and energy flux density when pressure waves are transmitted through different tissue interfaces. This demonstrates the potential for enhancing treatment efficacy and optimizing treatment doses for musculoskeletal disorders using simulation-based approaches.