Bile duct stones are a type of gallstone disease and are divided into primary bile duct stones and secondary bile duct stones. Primary bile duct stones are stones that originate in the bile duct system, while secondary stones are stones that drain from the gallbladder into the common bile duct. Primary bile duct stones include intrahepatic and extrahepatic bile duct stones. The typical clinical manifestation of common bile duct stones is recurrent biliary colic, and if accompanied by chills and high fever and jaundice, it is acute cholangitis, clinically we call it (Charcot) Charcot’s triad, which is easily life-threatening and must be seen and treated as early as possible. Most patients will have a sudden onset of right-sided colic under the glabella, which can radiate to the back of the right shoulder. However, a few patients will be completely painless and feel only a dull and uncomfortable upper abdomen. Jaundice usually appears 12-24 hours after the onset of abdominal pain and is obstructive and has a fluctuating character. Jaundice is associated with darkening of the urine, lightening of the feces, and itching of the skin. On physical examination there will be pressure pain and muscle tension in the epigastrium and right epigastrium. Clinical symptoms of intrahepatic bile duct stones are atypical and may be asymptomatic or with epigastric discomfort during the interval of the disease. In the acute phase, symptoms of acute cholangitis may occur, namely abdominal pain, chills and high fever, and jaundice when the stones cause bile duct obstruction, which may manifest as yellow urine or even a strong tea-like color, and yellowing of the eyes and skin. Repeated cholangitis can also lead to multiple liver abscesses. In summary, if symptoms of bile duct stones appear, prompt medical attention is needed, which is mainly surgical or endoscopic treatment.