Abstract: OBJECTIVE To study the clinical effect of Chaishao Sijin Decoction in preventing recurrence of choledocholithiasis after ERCP. METHODS 120 cases of ERCP for choledocholithiasis from January 2014 to December 2016 in gastroenterology and hepatology department of Kunshan Hospital of Traditional Chinese Medicine were selected. They were randomly divided into treatment group and control group according to the random number table， 60 cases in each group. The treatment group was treated with 400 ml Chaishao Sijin Decoction orally one dose a day， take it warm and twice in the morning and evening. Add or subtract herbs according to the syndrome. The control group was given by 250 mg ursodeoxycholic acid orally three times a day. Two groups were treated continuously for 6 months. The indexes of the serum total bilirubin (Tbil)， direct bilirubin (Dbil)， alkaline phosphatase (ALP)， glutamyl transferase (GGT)， clinical symptoms (including abdominal pain， abdominal distention， nausea， poor appetite) were detected in two weeks after the surgery. Recurrence of choledocholithiasis were recorded 6， 12 and 18 months after operation. RESULTS The recurrence rate of choledocholithiasis in treatment group 6， 12 and 18 months after operation was slightly lower than that in control group but the difference was not statistically significant ( P >0.05); The treatment group was superior to the control group in improving symptoms of abdominal pain， abdominal distension， nausea and poor appetite ( P <0.05); The treatment group was superior to the control group in improving serum Tbil， Dbil， ALP and GGT( P <0.01). CONCLUSION Chaishao Sijin Decoction can effectively prevent recurrence of choledocholithiasis after ERCP and improve clinical symptoms and serum biochemical indexes caused by choledocholithiasis.