This is a video highlighting the utility of a high resolution digital choledochoscope to extract stones from a 44 year old patient with hepaticocholedocholithiasis. During our outpatient workup, an MRCP demonstrated numerous stones throughout the entirety of the patient's intrahepatic and extrahepatic biliary tree, concerning for primary choledocholithiasis. While this diagnosis is more common in southeast Asian countries, risk factors include mechanical obstruction or chronic medical conditions that lead to biliary stasis. Although most general surgeons are adept with traditional methods of clearing stones from the common bile duct, the magnitude and proximal extent of stones found in primary common bile duct stone formers such as our patient require more complex techniques for clearing stones. Described advanced techniques include mechanical and laser-directed lithotripsy with cholangioscopy. In extreme cases, partial hepatectomy may be required if proximal stones are unable to be cleared from the intrahepatic biliary tree. In our case, the use of a high resolution digital choledochoscope to visualize stones in the hepatic ducts and the intrahepatic biliary tree allowed us to utilize a multitude of techniques well within the scope of general surgery to adequately clear the extensive burden of stones throughout the patient's biliary tree with the aid of new technology. After confirming with direct visualization that there were no more retained stones, we performed a side-to-side choledochoduodenostomy to provide long-term decompression of the biliary system, and the patient was discharged on a lifelong prescription of ursodiol after doing well in the postoperative period.