Objective: To investigate the clinical effect and safety of laparoscopic cholecystectomy and common bile duct exploration (LCBDE) in the treatment of elderly patients with gallbladder disease and concomitant common bile duct stones. Methods: The clinical data of elderly patients (≥60 years of age) with gallbladder disease and common bile duct stones undergoing LCBDE treatment (LCBDE group, n=60) or endoscopic sphincterotomy (EST) plus laparoscopic cholecystectomy (LC) (LC-EST group, n=60) were retrospectively analyzed. Results: The preoperative data between the two groups of patients were comparable. The operative time, length of postoperative hospital stay and incidence of operative complications in LCBDE group were significantly decreased compared with LC-EST group (all P<0.05), while there was no significant difference between the two groups with regard to intraoperative blood loss, time to first postoperative flatus, and the rate of surgical success, open conversion and one-session stone clearance (all P>0.05). Conclusion: LCEST has similar therapeutic effect with LC plus EST in treatment of elderly patients with gallbladder disease and common bile duct stones, but it also has the advantages of short operative time, quick recovery and low incidence of complications.