Gallstone disease includes stones originating from the gallbladder and from the bile duct system, and its clinical manifestations vary. Gallbladder stones often present as pain in the upper abdomen or right upper abdomen, which may be vague, dull or colicky, and may spread to the right shoulder, often accompanied by gastrointestinal symptoms such as nausea, vomiting, loss of appetite, abdominal distension, constipation or diarrhea, etc. In severe cases, there may be fever and jaundice, and recurrent attacks. Although abdominal pain is the main symptom of gallbladder stones, the presence or absence of pain and its severity depend on the size and location of the stone, the presence or absence of infection, and whether it causes obstruction. When stones move and cause damage to the gallbladder mucosa or bacterial infection, cholecystitis may cause persistent dull pain, stabbing pain, swelling pain, and in severe cases (about 30%) the pain may be very intense and may spread to the right shoulder; when stones are embedded in the gallbladder neck or the gallbladder duct, they often present as severe colic. About 50% of patients with gallbladder stones detected as symptomatic have recurrence of symptoms within 5-10 years, while about 25% of patients with asymptomatic gallbladder stones have symptoms within 10 years or have undergone cholecystectomy for some reason. Common bile duct stones can be primary in the common bile duct and coexist with intrahepatic bile duct stones, or secondary to gallbladder stones. The main symptoms are pain, fever and jaundice when the stone causes obstruction in the lower part of the common bile duct, which is known as Charcot’s triad. When combined with septic infection, the abdominal pain is persistent and severe, the fever persists, the jaundice is progressively worse, and the blood pressure may drop and the mental disorder may appear, which requires emergency surgery. Intrahepatic bile duct stones can coexist with common bile duct stones. When they are not combined with common bile duct stones and do not cause bile duct obstruction and bile duct inflammation, they can be asymptomatic or have some atypical mild symptoms. The common symptoms are vague discomfort in the liver area, often persistent dull pain, and the location of the pain is related to the internal position of the stone in the liver. When one side of intrahepatic bile duct obstruction is combined with infection, it causes acute obstructive cholangitis in the corresponding area, which may present with chills, fever, epigastric pain, decreased blood pressure and liver function damage, but rarely jaundice. When intrahepatic bile duct stones obstruct both left and right bile ducts or coexist with common bile duct stones, they are often combined with more severe bile duct inflammation and may present with severe pain, high fever and jaundice, i.e. Charcot’s triad. On examination, patients with intrahepatic bile duct stones may have asymmetric enlargement of the liver and pressure or crushing pain in the liver area. Advanced patients often develop cirrhosis, portal hypertension with splenomegaly, esophageal varices and gastrointestinal bleeding, ascites, etc. In addition to the above mentioned history and symptoms, imaging is very important in the diagnosis of cholelithiasis. With the continuous development and progress of medicine, most of the gallstone patients can be diagnosed clearly. Ultrasound and CT examinations can reveal whether the gallbladder is enlarged, whether the gallbladder wall is thickened, whether there is inflammatory reaction, whether there are stones in the cyst, the size and shape of the stones and their specific location in the cyst; whether the intrahepatic bile ducts and common bile ducts are dilated and whether there are stone shadows, as well as the size, number and location of the stones. Percutaneous hepatic percutaneous cholangiography (PTC) or endoscopic retrograde cholangiopancreatography (ERCP) can clearly show the overall image of the bile ducts inside and outside the liver, and can clarify the location, number and size of stones, the degree of bile duct dilatation and obstruction, thus providing a very important basis for the treatment of gallstone disease.