Background. Choledocolithiasis is a late complication in the evolution of biliary lithiasis. More frequently, the main bile duct approach is performed by new miniinvasive methods. Case report. A 38 y/o female was diagnosed and treated in SOROKA Medical Center Beersheba in 2016. The patient was afebrile, haemodynamically stable, yet presented jaundice. The abdomen was soft, mildly tender at palpation, with a negative Murphy’s sign. Blood tests identified: WBC 4.6 x 109/L, AST 258 IU/L, ALT 352 IU/L, billirubin 77 umol/L, alkaline phosphatase 258 IU/L. The ultrasound investigation detected a dilated CBD (14 mm) containing two stones. MRCP confirms two ductal stones of 8 and 10 mm, and a dilated duct. ERCP identified two stones of 8 and 10 mm that couldn’t be removed, so a stent was placed and a sphincterotomy was performed. Percutaneous transhepatic cholangiography and cannulation guide wire technique was used, with a modified Burhenne technique. Stones were pushed into the duodenum with Fogarty Balloon, stent inserted. Post interventional radiology revealed that CBD was cleared. Patient made good recovery. Conclusions. Elective methods in the diagnosis of choledocholithiasis are MRCP in colangiographic regime, ERSP and percutaneous transhepatic cholangiography. Modified Burhenne technique can be used in treating choledocholithiasis.