Objective To observe and analyze the duodenal papilla diseases associated with recurrent choledocholithiasis. Methods A total of 614 patients with choledocholithiasis who had been treated with endoscopic retrograde cholangiopancreatography and without endoscopy or surgery of duodenal papilla were analyzed retrospectively from January 1, 2018 to June 30, 2020 in our hospital. Results Twenty patients with common bile duct stone extraction were studied as recurrent choledocholithiasis group, and 20 patients without biliary surgery or intervention were as initial choledocholithiasis group matched according to the age and gender. The number of patients with each duodenal papilla diseases in recurrent group were more than those in initial group. Parapapillary diverticulum was 9 vs. 5, long nipple 10 vs. 4, duodenal papillitis 2 vs. 0, atrophic papillitis 4 vs. 1 in both groups without statistically significant differences. There were more patients with duodenal papilla diseases in recurrent group than those in initial group. Normal nipple was 3 cases in recurrent group and 12 cases in initial group (P=0.008) with statistically significant difference. Conclusions More patients with recurrent choledocholithiasis had duodenal papilla disease and further studies are required for the mechanism of duoneal papilla disease associated with choledocholithiasis.