A new method of lithotripsy combining high and low frequency ultrasound has been investigated. This method controls generation of cavitation only on the stone surface and utilizes collapse pressure of the bubbles. In order to apply this method for clinical practice, it is important to monitor the process of stone crushing and behavior of cavitation from outside the body. In this study, ultrasound imaging was coupled with a therapeutic ultrasound system for real-time monitoring and targeting of stones. Stone crushing tests have been conducted in vitro and in vivo experiments. In vitro experiment, crushing process of a model stone in a polyacrylamide gel was observed with both ultrasound imaging and a digital video camera. It was observed with ultrasound imaging that the stone was crushed with ultrasound. In vivo experiment, a stone crushing experiment has been conducted in a pig bladder. And a mark of crushing was found on the surface of the stone taken out from the bladder after the irradiation, as well as in vitro experiment. The process of stone crushing in a pig bladder could be monitored with bi-plane ultrasound imaging from outside the body.