Objective: To compare the efficacy of laparoscopic and open left lateral hepatic lobectomy combined with choledochoscopic stone extraction for left hepatolithiasis. Methods: The clinical data of 45 patients with left intrahepatic duct stones treated from September 2010 to September 2013 were retrospective analyzed. Of the patients, 23 cases received laparoscopic left lateral hepatic lobectomy plus choledochoscopic stone extraction (laparoscopic group), and 22 cases were subjected to open left lateral hepatic lobectomy plus choledochoscopic stone removal (laparotomy group). Results: Laparoscopic group was superior to laparotomy group in the variables of time to regain ambulation, intestinal function recovery and food intake, length of postoperative stay and postoperative pain (all P<0.05), while the operative time, intraoperative blood loss, live function parameters and hospitalization costs between the two groups showed no significant difference (all P>0.05). After operation, no residual stone was noted in either of both groups of patients; bile leakage occurred in one case in laparoscopic group and biliary collection on the hepatic resection surface occurred in one case in laparotomy group respectively, which were all resolved by conservative treatment. Forty-three cases were followed up, in whom no stone recurrence, abdominal pain, jaundice or abnormal liver function was noted. Conclusion: Laparoscopic left lateral hepatic lobectomy plus choledochoscopic stone extraction has similar efficacy as open approach in treatment of left intrahepatic duct stones, but it allows a quick postoperative recovery, so it is recommended as the first therapeutic option for this condition.