Objective To explore the therapeutic effect of three lens combined with one-step method, endoscopic retrograde cholangiography, sphincterotomy (ERCP/EST) combined with laparoscopic cholecystectomy (LC) in choledocholithiasis and cholecystolithiasis.Methods 72 patients with choledocholithiasis and cholecystolithiasis from January 2018 to August 2019 were included in the study. All the patients were randomly divided into observation group and control group with 36 patients in each group. The observation group received three-lens combined with one-step therapy, while the control group received ERCP/EST combined with LC. The perioperative clinical indicators (intraoperative blood loss, postoperative defecation time, hospital stay, medical expenses, stone removal rate, conversion rate to laparotomy) and VAS scores at different postoperative points were compared between the two groups. In addition, complications occurred during hospitalization in the two groups were statistically analyzed.Results There was no significant difference in gender, age, body mass index and stone diameter between the two groups (P > 0.05). The amount of intraoperative blood loss, postoperative defecation time, hospital stay and medical expenses in the observation group were significantly lower than those in the control group, with statistically significant differences (P < 0.05).There was no significant difference in stone clearance rate and conversion rate between the two groups (P > 0.05). There was no significant difference in VAS score between the two groups at different time points (P > 0.05).The total incidence of postoperative complications in the observation group was 8.33%, which was significantly lower than that in the control group (27.78%) (P < 0.05).Conclusion Compared with ERCP/EST combined with Lc, three mirrors combined with "one-step method" in the treatment of choledocholithiasis combined with cholecystolithiasis have fast postoperative recovery, low economic pressure and low incidence of postoperative complications, which is worthy of clinical application.