Objective To evaluate the curative effect and prognosis of endoscopic papillary large balloon dilatation (EPLBD) in the treatment of choledocholithiasis. Methods A total of 153 patients with choledocholithiasis (>1.0 cm in stone diameter) admitted and treated in Shanxi People′s Hospital from August 2016 to November 2017 were randomly divided into two groups according to the random number table: the EPLBD group (n=83) and the small endoscopic sphincterotomy plus large balloon dilatation (ESLBD) group (n=70). The success rate of stone removal,the rate of lithotripsy, and the incidence of short-term and long-term complications were compared between the two groups. Results There were no statistical differences between the EPLBD group and the ESLBD group in total stone removal rate [95.2% (79/83) VS 97.1% (68/70), χ2=0.388, P=0.533] and one-time stone removal rate [92.8% (77/83) VS 90.0% (63/70), χ2=0.375, P=0.540]. The lithotripsy rate between the two groups had no statistical difference [25.3% (21/83) VS 35.7% (25/70), χ2=1.958, P=0.162]. There was no statistical difference in the incidence of recent complications between the two groups [43.4% (36/83) VS 40.0% (28/70), χ2=0.178, P=0.673]. No postoperative perforation was found in either group. The follow-up time was 22.7±4.3 months in the EPLBD group, and 20.8±6.3 months in the ESLBD group.The cumulative recurrent rate of choledocholithiasis in the two groups were 2.4% (2/83) and 15.7% (11/70), respectively, and the difference was significant (P=0.003). Conclusion Simple EPLBD in the treatment of choledocholithiasis is equivalent to ESLBD in the success rate of stone removal, utilization rate of lithotripsy, and incidence of recent complications, but the long-term stone recurrence rate of EPLBD is lower than that of ESLBD. EPLBD is effective and safe on the treatment of choledocholithiasis.