Hepatolithiasis is one of the most prevalent benign biliary tract diseases in Southwest China,and surgery is the optimal treatment for this disease. However,hepatolithiasis has insidious onset and complicated course,as well as high rate of residual stones and recurrence and high incidence of cholangiocarcinoma after operation,and some patients undergo surgery several times due to inappropriate initial therapeutic strategy,resulting in more severe condition and more difficult treatment. Therefore,initial surgical treatment is the key to the short-term and long- term outcomes of hepatolithiasis. For previously untreated patients,comprehensive diagnosis and adequate disease assessment,standardized and individualized therapeutic strategy,and appropriate operation time are warranted,the procedures based on hepatic segments and hepatic lobes are preferred,and the choledochoscope and B- mode ultrasound should be properly used during the operation,so as to resect the lesions,prevent recurrence,and reduce the reoperation rate.