Objective: To investigate the efficacy of using fast-track surgery (FTS) in perioperative management of hepatolithiasis patients. Methods: The clinical data of 132 patients with hepatolithiasis undergoing surgical treatment from July 2005 to June 2012 were reviewed. According to the type of perioperative management, patients were divided into FTS group (56 cases) and control group (76 cases); patients in FTS group received the new perioperative care procedure, namely the fast-track methodology, while those in control group underwent the conventional perioperative treatment. Results: Compared with control group, the length of postoperative hospital stay, medical costs and incidence of postoperative complications and wound infection were reduced, and the times to drainage tube removal and first postoperative passage of flatus were shortened in FTS group (all P<0.05). Multivariate Logistic regression analysis for the entire group of patients revealed that age, previous history of biliary surgery, intraoperative wound edge protection and time of drainage tube removal were affecting factors for the incidence of wound infection (all P<0.05). Conclusion: The application of FTS in management of hepatolithiasis patients is safe and effective, and can reduce the incidence of postoperative complications and medical costs, as well as shorten the postoperative hospital stay and accelerate recovery of the patients.