Recurrence of bile duct stones after endoscopic stone removal has been reported ranging from 4 to 24%. The risk of late complications such as stone recurrence is an important issue, especially for relatively young, otherwise healthy, patients with many years of future exposure time. The risk factors true recurrence of bile duct stones after endoscopic sphincterotomy (EST) and stone clearance are suboptimally defined. If patients at significant risk for stone recurrence could be identified, closer follow-up, earlier intervention, and possible preventive measures could theoretically decrease stone recurrence and late complications. The majority of patients with common bile duct stone who have EST and stone clearance will have no further biliary events during the remainder of their life. Whether identifying risk factors for recurrence can improve outcomes by prophylactic treatments or earlier interventions needs further prospective study.