Abstract: The development of biliary tract surgery in China is closely related to the changes in the spectrum of biliary tract diseases and the improvement of treatment measures. Although significant progress has been made in academic research, hardware conditions, treatment modes, and surgical techniques, there are still many challenging issues that involve multiple levels of clinical work for benign and malignant biliary tract diseases. The most prominent issues are the diagnosis and treatment standards for benign biliary tract diseases, the management paradigm for complex intrahepatic and extrahepatic calculus of bile duct, improving the prevention and treatment effects of iatrogenic bile duct injury, and the comprehensive treatment concept for malignant biliary tract tumor. The authors believe that it is necessary to timely update the treatment mode, standardize the disease management process and surgical technical standards, and apply them to various aspects of clinical work in order to fundamentally solve the difficulties faced by biliary tract surgery in China.