Common bile duct stones often lead to acute biliary obstruction, cholangitis and pancreatitis. Endoscopic stone extraction has become the main treatment for bile duct stones. Most of the common bile duct stones can be removed by the conventional endoscopic method, but there are still 10% to 15% of the complex choledocholithiasis that need the combined treatment of endoscopic lithotripsy. The authors review and summarize the current endoscopic management options for complex choledocholithiasis, such as endoscopic balloon papillary dilatation, endoscopic guided lithotripsy and endoscopic ultrasound-guided choledocholithotomy, so as to provide endoscopic diagnosis and treatment suggestions and basis for the clinical treatment of refractory choledocholithiasis.