Common bile duct (CBD) stone management has evolved significantly with technological advances and an improved understanding of pathophysiology. This comprehensive review examines current evidence and emerging trends in CBD stone management, emphasizing modern diagnostic approaches and treatment paradigms. Recent developments in imaging techniques, including AI-assisted analysis, have enhanced diagnostic accuracy. Treatment strategies now emphasize minimally invasive approaches, with endoscopic techniques showing success rates exceeding 90% in experienced centers. Special considerations for specific populations, including elderly patients and those with altered anatomy, have led to refined management algorithms. Future directions include novel stone fragmentation technologies, biodegradable materials, and personalized medicine approaches. The integration of these advances, combined with a multidisciplinary approach, has improved patient outcomes while presenting new opportunities for enhanced care delivery. Continued technological innovation and refined techniques suggest a promising future for CBD stone management, although challenges remain in optimizing treatment selection and preventing recurrence.