Objective: To compare the clinical efficacies among laparoscopic, minilaparotomy and conventional open choledocholithotomy. Methods: The clinical data of 217 patients with cholecystolithiasis and choledocholithiasis undergoing surgical treatment in recent five years were analyzed. Of the patients, 69 cases underwent laparoscopic procedure (laparoscopic group), laparoscopic cholecystectomy (LC) plus laparoscopic common bile duct exploration (LCBDE); 85 cases underwent minilaparotomy surgery (minilaparotomy group), LC plus open choledocholithotomy via a small laparotomy incision; and 63 cases underwent conventional open surgery (open surgery group), open cholecystectomy and choledocholithotomy. The related clinical indexes among the three groups were compared and analyzed. Results: The intraoperative bleeding volume, time to bowel function recovery, postoperative pain, complication incidence and hospital stay of the laparoscopic group and minilaparotomy group were significantly better than those of the open surgery group. The average time of operation and pneumoperitoneum in the minilaparotomy group were shorter than those in the laparoscopic group (both P<0.05). Conclusion: Both LCBDE and auxiliary minilaparotomy surgery have the advantages of minimal invasion, quicker recovery and less pain. Minilaparotomy procedure can shorten the operative and pneumoperitoneum time compared with LCBDE, so it is especially suitable for patients who cannot tolerate a long pneumoperitoneum time and elderly patients with poor cardiopulmonary function.