Introduction: Difficult common bile duct(CBD) stone often requires mechanical lithotripsy for successful extraction. But we can experience several complications such as trapped or broken basket, wire fracture, broken handle during the mechanical lithotripsy. These complications can be managed by additional endoscopic procedure or emergent mechanical lithotripsy. But peroral direct choledochoscopic treatment of complicated stone during mechanical lithotripsy have not be reported. We present a case of impacted CBD stone with basket in distal CBD successfully treated with peroral cholangioscopy-directed elctrohydraulic lithotripsy(EHL). Case report: A 79-year-old female visit out hospital due to abdominal pain. Abdominal computed tomography(CT) revealed large stone in CBD. About 3x4cm sized large fi lling defect was noted in CBD on ERCP. Endoscopic papillary large balloon dilatation after endoscopic sphinterectomy(EST), We tried mechanical lithotripsy. But the stone was too hard to crushed by mechanical lithotripsy. During additional emergent mechanical lithotripsy the wire was broken at 30cm away from mouth with the dormia basket entrapped in the distal CBD with the stone. We performed peroral direct cholangioscopy with ultra-slim endoscopy. The endoscopic fi nding showed basket-captured large brown stone at distal CBD, just above papillary orifi ce. We tried peroral cholangioscopy-directed elctrohydraulic lithotripsy and succeeded in breaking the stone. After removing the trapped basket from the fragmented stones, We extracted the stone successfully. Conclusion: Several clinical studies reported the utility of peroral cholaniograpy for the diagnosis and management of bile duct disease. We suggest that electrohydraulic lithotripsy under direct peroral cholangioscopy can be an effective and safe therapeutic option for treatment of impacted stone during mechanical lithotripsy.