OBJECTIVE To evaluate the importance of sphincter of Oddi laxity (SOL) in hepatolithiasis (HL). METHODS Subjects included 98 patients diagnosed with HL between 2002 and 2007. Detailed histories were taken and the subjects were monitored until July 2008. HL patients were divided into two groups: Group I included 45 patients with SOL, and Group II included 53 patients without. Recurrence and reoperation indices of both groups were calculated and compared. RESULTS The recurrence index was 0.135 in Group I and 0.018 in Group II (P < 0.001). The reoperation index was 0.070 in Group I and 0.010 in Group II (P < 0.001). The mean frequency of biliary operation was 2.07 in Group I and 1.21 in Group II (P = 0.001). Differences between the two groups are significant. CONCLUSIONS HL patients with SOL tend to have a higher risk of recurrence and a larger demand for reoperation than those without this condition.