Abstract: Objective To further understand choledocholithiasis, so as to reduce the misdiagnosis and missed diagnosis in clinical work.Methods The clinical data of 103 patients with choledocholithiasis which were misdiagnosis and missed diagnosis during the course of diseases and diagnosis by endoscopic retrograde cholangiopancreatography in our hospital between August 2005 and July 2010.The clinical features of the patients and treatment were summarized.Results Among 103 patients, 29 (37.2%) were misdiagnosis stomach disease, 23 (29.5%) were misdiagnosis acute and chronic hepatitis, 14 were misdiagnosis coronary heart disease and 12 (15.4%) were misdiagnosis cold.In patients with both cholecystolithiasis and choledocholithiasis, 25 were missed diagnosis choledocholithiasis.Among 103 patients, 75 (72.8%) were elder than 65 years old.The patients usually presented with fever (n=95, 92.2%) , abdominal pain (n=87, 84.5%) , jaundice (n=79, 84.5%) , nausea and vomiting (n=54, 52.4%) .All the patients had abnormal liver function, 98 (95.1%) had leukocytosis, and 78 (75.7%) had abnormal electrocardiogram.Ultrasonography was the first diagnoses of choledocholithiasis, others were MRCP and CT.Conclusion Examining the patients more carefully and analyzed the abnormal exam can reduce the misdiagnosis and missed diagnosis of choledocholithiasis.