On the basis of results of surgical treatment of 85 patients with intrahepatic gallstones, effective methods for surgical treatment of this disease were discussed. Operative mortality rate for these patients was 10.6%. Most fatal cases had long duration of symptoms and showed evidence of hepatic fibrosis or biliary cirrhosis at the time of operation. In cases of long duration of symptoms, it is generally necessary to thoroughly examine prior to operation the presence or absence of liver parenchymal injury and to pay deliberate attention to minimizing operative intervention. Especially, in hepatic lobectomy, its indication must be scrutinized carefully assessing the patient''s condition. In a follow-up study, 80% of the patients were found living with almost no complaints, 5 patients having occasional bouts of cholangitic attack included 3 patients who had left the hospital having residual gallstones. Including these 3 patients, 7/9 patients with residual gallstones showed severe hepatic dysfunction. Indications of the operations for different types of patients with intrahepatic gallstones were evaluated as satisfactory. For the favorable management of intrahepatic gallstones, 2 points are specially emphasized: thorough scrutinization of liver parenchymal disorder prior to operation and long-term observation for care of survivors with residual gallstones.