Approximately 6% of the global population has gallstones. Acute cholecystitis affects approximately 200,000 individuals annually in the United States. Laparoscopic or open cholecystectomy is the definitive treatment, but many patients are ineligible due to comorbidities. For these high-risk patients, percutaneous cholecystostomy is a temporary alternative; however long-term use in patients with continued contraindications to surgery affects quality of life and has a high complication rate. Percutaneous cholecystoscopic lithotripsy/lithectomy has emerged as a viable alternative for managing these patients. Recent advancements in endoscopic and lithotripsy devices have enhanced outcomes. This review will discuss the technical aspects and outcomes of percutaneous gallstone lithotripsy/lithectomy (in the gallbladder and bile ducts).