Management of common bile duct stones has changed rapidly as new developments in surgical and endoscopic equipment have become available. Prior to advanced laparoscopic surgical techniques and endoscopic sphincterotomy, common bile duct stones required open surgery, choledochotomy, and manual removal. New alternatives in the management of choledocholithiasis must be understood to allow for comprehensive management of common bile duct stones. Endoscopic and surgical techniques can also be combined for excellent results utilizing minimally invasive techniques. The appropriate choice of therapy will depend on the experience and the resources available.