Objective To study the clinical characteristics and quality of life in elderly patients undergoing multiple surgeries for intrahepatic and extrahepatic bile duct stones. Methods Patients with multiple surgeries for intrahepatic and extrahepatic bile duct stones in Beijing Chaoyang Hospital of Capital Medical University from January 2019 to January 2022 were included as the study subjects. According to age, they were divided into an elderly group (age ≥60 years; n=64) and a middle-aged group (aged 45-60 years; n=66). The general demographic data, data of previous biliary tract surgery, and data of the current surgery were collected and analyzed in both groups, and the clinical characteristics of the elderly group were analyzed. The patients were followed up after surgery until October 2023. The postoperative quality of life was investigated in elderly patients undergoing multiple surgeries for intrahepatic and extrahepatic bile duct stones using the 36-item short-form health survey (SF-36). SPSS statistics 19.0 was used for statistical analysis. Data comparison between two groups was perfomed using t test,χ² test or rank-sum test depending on data type. Results The age in the elderly group was older than in the middle-aged group, the proportions of patients with type 2 diabetes mellitus (T2DM), hypertension, respiratory system diseases and coronary heart disease in the elderly group were higher than those in the middle-aged group, and the differences were statistically significant (P<0.05 for all). There were no statistically significant differences in the number of previous biliary tract surgeries, the reason for the first surgery and the method of the first surgery between the two groups. The reasons for the current surgery in the two groups were stone residual or recurrent stones. The interval between the last surgery and the current surgery was longer in the elderly group than in the middle-aged group. The proportions of patients with clinical upper abdominal pain and fever were lower, while the proportion of patients with extrahepatic bile duct stones was higher in the elderly group than in the middle-aged group. The stone diameter was larger, the proportion of patients with combined surgical treatment was higher, the surgical time and hospital stay were longer, the intraoperative blood loss and the incidence rates of postoperative complications were higher in the elderly group than in the middle-aged group (P<0.05). The scores of dimensions and total score of quality of life on SF-36 scale in the two groups at 6 months after surgery increased as compared with those before surgery, and the differences were statistically significant (P<0.05 for all). The scores of physical function (PF), role physical (RP) and general health (GH), and SF-36 total score were higher in the middle-aged group compared to the elderly group at 6 months after surgery (P<0.05). Conclusion The reason for the current surgery in patients of different ages with multiple surgeries for intrahepatic and extrahepatic bile duct stones was stone residual or recurrence. However, the preoperative clinical symptoms were not obvious in the elderly group. In addition, the elderly patients had more underlying diseases, longer interval between last surgery and the current surgery, lareger stone diameters, and more complex surgical regimen, thus it is necessary to pay attention to the surgical risk control and postoperative complication management.