Objective To evaluate the clinical effect of holmium laser lithotripsy combined with fiber choledochoscope in the treatment of intra- and extra- hepatolithiasis. Methods Sixty- four patients who were diagnosed with intra- and extra- hepatolithiasis in our hospital from January 2012 to July 2014 were assigned to receive fiber choledochoscope treatment( 33 cases) or holmium laser lithotripsy combined with fiber choledochoscope( 31 cases). The one- time stone removal rate and incidence of complications were compared between the two groups. Comparison of categorical data was made by chi- square test,while comparison of continuous data was made by t test. Results The fiber choledochoscope group had a significantly lower one- time stone removal rate and a significantly higher incidence of complications compared with the combination therapy group( 72. 73%( 24 /33) vs 93. 55%( 29 /31),χ2= 4. 868,P = 0. 027; 21. 21%( 7 /33) vs3. 23%( 1 /31),χ2= 4. 728,P = 0. 030). Conclusion Holmium laser combined with fiber choledochoscope can effectively increase the one- time stone removal rate and reduce the incidence of complications in patients with intra- and extra- hepatolithiasis. This therapy holds promise for clinical application.