Objective：To explore the diagnosis and surgical treatment of gallstone ileus.
Methods：We retrospectively analysed the diagnosis,treatment and follow-up outcome of 18 patients with gallstone ileus. 
Results：There were 18 patients with mean age of 64.3 years and a male to female ratio of 1∶5. Preoperative diagnosis rate was 77.8%. All 18 patients underwent laparotomy.Three patients underwent enterolithotomy alone,eight had two-stage procedure and six had one-stage procedure; 1 patient, who undergoing biliary enteric drainage before, underwent one-stage enterolithotomy, plastic surgery of biliary-enteric anastomosis and lithotomy. The perioperative complication rate was 38.9% and the main complications were wound infection and pulmonary infection. One patient died from myocardial infarction,  the perioperative mortality rate was 5.5%.
Conclusions：Elderly female patients are more susceptible to gallstone ileus. Effective use of imaging techniques can provide a timely diagnosis and reliable basis for the treatment of gallstone ileus. Surgical intervention should be adopted as soon as possible and must be individualized.