Recurrent pyogenic cholangitis (Hepatolithiasis) constitutes around 15% of gallstone disease in Kashmir. Patients with hepatolithiasis have mutilating hepatic duct disease, causing life long suffering with recurrent attacks of cholangitis. The disease is difficult to manage and needs multidisciplinary approach. Cause of formation of such stones is not known. The study conclusively showed that hepatolithiasis in Kashmir is an aftermath of recurrent invasion of the bile ducts by Ascaris lumbricoides (Biliary ascariasis). The clinicians should be aware of relationship between biliary ascariasis and hepatolithiasis and apply this knowledge in their routine clinical practice.