Objective: To investigate the method of surgical treatment and clinical efficacy of hepatolithiasis with bile duct stricture. Methods: The clinical data of 62 patients with hepatolithiasis concomitant with bile duct stricture treated between January 2008 and November 2012 were retrospectively analyzed. These patients were divided into observational group and control group according to the surgical methods used. All patients in observational group underwent caudate lobe resection during surgery, while those in control group received surgical treatments without caudate lobe resection. The clinical efficacy, incidence of postoperative residual stones and complications, recurrence and alterations of liver function before and after surgery between the two groups were compared. Results: No death occurred in either group of patients. In observational group compared with control group, the excellent rate of clinical efficacy was improved (93.2% vs. 77.8%), the incidence of postoperative residual stones and complications as well as recurrence rate was significantly decreased (9.1% vs. 27.8%; 9.1% vs. 22.2%; 2.2% vs. 16.7%), and all the differences had statistical significance (all P<0.05). The preoperative liver function enzymes of the two groups showed no statistical difference (all P>0.05), and all were improved at time of hospital discharge, but all the enzyme parameters were improved significantly better in observational group than those in control group (all P<0.05). Conclusion: In surgical treatment of hepatolithiasis with bile duct stricture, caudate lobe resection can improve the surgical efficacy, reduce the rate of residual stones, and improve the liver function of these patients.