Abstract： Gallstones are a common disease of the digestive system that severely affects patients′ quality of life. Although the disease is located in the gallbladder，its origin lies in the liver，and gallbladder diseases should be treated from the perspective of the liver. The theory of "liver as the instigator of the five zang-organs" suggests that gallstone formation and progression can be caused by liver-specific pathologies such as liver qi stagnation， gallbladder qi constraint，phlegm-stasis accumulation in the gallbladder，prolonged stagnation transforming into fire and condensing into gallstones，as well as blood and yin consumption，and liver-induced metabolic disorders affecting other organs. It emphasizes treating gallstones by focusing on the liver， including soothing the liver to relieve stagnation， resolving phlegm and removing stasis； clearing heat and nourishing yin， promoting bile flow and expelling stones； nourishing the liver and regulating other zang-organs to restore systemic balance and treat associated zang-organ dysfunctions. This approach aims to provide new ideas and methods for the prevention and treatment of gallstones with traditional Chinese medicine.