［Abstract］ Objective To compare endoscopic sphincterotomy ( EST ) and endoscopic papillary balloon dilation ( EPBD ) in the treatment of extrahepatic bile duct stones in terms of similarities and differences. Methods Clinical data of 277 patients with extrahepatic bile duct stones from August 2009 to July 2011 in gastroenterology department of Shanghai Changhai Hospital were retrospectively analyzed. 168 of the 277 patients received EST and the other 109 received EPBD.The general case, stone diameter, stone extraction method, operation time, stone once complete clearance rate, postoperative hospital stay and short-term complications of EST group and EPBD group were compared. Results There was no statistic difference in the age, sex ratio, combined duodenal diverticulum between two groups .The stone diameter was (11.3+6.2 ) mm in EST group and that was (10.1+5.7 ) mm in EPBD group. There was no statistic difference between them( P=0.1056 ). There was no statistic difference in the stone extraction method between EST group and EPBD group. The operation time was (21.2+3.1)min in EST group and that was (20.7+2.5) min in EPBD group. There was no statistic difference between them(P=0.1591). The stone once complete clearance rate was 95.2% in EST group and that was 94.5% in EPBD group. There was no statistic difference between them( P=0.7828 ).The postoperative hospital stay was ( 4.1+1.9 ) day in EST group and that was ( 4.1+2.0 ) day in EPBD group. There was no statistic difference between them( P=1.0000 ).The incidence of short-term complications was 10.1% in EST group and that was 12.8% in EPBD group. There was no statistic difference between them( P=0.4822 ).The incidence of hemorrhage was 3.6% in EST group and that was 0 in EPBD group. There was statistic difference between them( P<0.05 ). The incidence of hyperamylasemia was 8.3% in EPBD group and that was 2.4% in EST group. There was statistic difference between them( P<0.05 ). Conclusion EST and EPBD each have advantages and disadvantages in the treatment of extrahepatic bile duct stones . Suitable operation mode should be chosen by the specific situation of patients and not limited to the size of the stones.