The management of choledocholithiasis can be a challenging problem depending on the number, size, and location of the stones. Therapeutic endoscopic retrograde cholangiopancreatography (ERCP) has been the standard of care for decades. Various tools and techniques have been used during ERCP including, but not limited to, sphincteroplasty, extraction balloon, mechanical lithotripsy with trapezoid basket, extracorporeal shockwave lithotripsy, and direct cholangioscopy with lithotripsy. Residual stones may remain even after adequate balloon sweeps and negative occlusion cholangiogram, especially if the bile duct is dilated and stones are small, escaping the balloon sweeps [1]. Direct cholangioscopy has proven to be a useful tool in directly visualizing the ducts for any residual stones in order to achieve complete clearance [2] [3].