Objective: To investigate the clinical efficacy of precise hepatectomy for complicated hepatolithiasis. Methods: The clinical data of 60 patients with complicated hepatolithiasis undergoing precise hepatectomy within the last two years were retrospectively analyzed. Results: The operations were performed successfully in all patients. The average operative time was (358.60±45.6) min, intraoperative blood loss was (598.2±95.6) mL and length of postoperative hospital stay was (12.5±2.7) d. Postoperative complications occurred in 11 cases (18.3%) and included 5 cases (8.3%) of wound infection, 1 case (1.7%) of bile leakage, 3 cases (5.0%) of right pleural effusion, and 2 cases (3.3%) of lung infection. During the follow-up period of 2 months to 2 years, residual stones were found in 3 patients (5.0%), which were removed by choledochofiberscope through T-tube sinus tract, and recurrence occurred in 2 patients (3.3%) who were treated again by endoscpic sphincterotomy (EST) to extract stones. Conclusion: Precise hepatectomy is effective for treatment of complicated hepatolithiasis, which can reduce the rate of residual and recurrent stones and reoperation.