OBJECTIVE To assess the safety and effect of endoscopic sphincterotomy (EST) and endoscopic papillary balloon dilatation (EPBD) for choledocholithiasis. METHODS 328 patients with choledocholithiasis were subjected to EST or EPBD; they included 174 patients with single stone, 112 patients with two stones and 42 patients with three stones (one patient with 20 stones). Patients with stones less than 10 mm in diameter underwent EPBD and those with stones larger than 11 mm in diameter underwent EST. RESULTS EST and EPBD succeeded in 323 patients (98.5%), and failed in 5. Stones in 98 patients were excluded spontaneously after endoscopic therapy. 207 patients were subjected to basket or balloon stone extraction. Stones in 14 patients were discharged by basket lithotripsy. Four patients were given wave lithotripsy. Stones in 22 of the 323 patients were extracted thoroughly after 2-3 times attempts. Total complications were noted in 2.5% of the patients. Hemorrhage from the gastrointestinal tract was seen in one patient, cholangitis in 4 patients, and pancreatitis in 3 patients. In 92 patients receiving digestive tract barium X-ray examination, 86 developed no barium reflux to the baliary tract, 2 pneumobilia, 4 barium reflux to the biliary tract. CONCLUSIONS EST and EPBD are relatively safe and effective in treatment of choledocholithiasis, and have few complications.