Bile duct stones mainly refer to intrahepatic bile duct stones and common bile duct stones, while gallstones usually refer to gallbladder stones. The difference between gallstones and bile duct stones is mainly in the following two points: first, from the composition and etiology of the stones, gallstones, also known as gallbladder stones, are mainly cholesterol stones, and the etiology is mainly related to the imbalance of bile acid and cholesterol dissolution, and gallbladder contraction. In contrast, bile duct stones are mainly bile pigment stones or bile pigment-based mixed stones, and the cause is mainly related to bile duct bacterial infection. Second, from the symptoms and treatment, most of the gallbladder stones are static stones or asymptomatic stones, and some patients have acute cholecystitis, mainly manifested by pain and discomfort in the right upper abdomen, usually rarely jaundice. In contrast, bile duct stones have abdominal pain and are prone to jaundice because of bile duct obstruction. In terms of treatment, quiescent gallbladder stones are usually closely monitored. If there are episodes of acute cholecystitis or recurrent episodes of chronic cholecystitis, surgical treatment may be considered. Surgical treatment is usually simple cholecystectomy, either laparoscopic or open surgery. In contrast, bile duct stones, once detected, usually require prompt surgical treatment, otherwise they are prone to episodes of acute cholangitis or even infectious shock.