Objective <p>This study aims to assess the safety and effectiveness of percutaneous papillary balloon dilation for treating common bile duct stones (CBDS), which can provide more evidence to assist clinicians in making decisions when endoscopy or surgery is not feasible for patients.</p> Materials and methods <p>A search of the PubMed, EMBASE, and Cochrane databases was conducted spanning from January 1, 2000, to May 1, 2024. Measured outcomes included common bile duct stone clearance rates and complication rates. Pooled data were assessed using a random-effects model in the Stata software. I² was used to assess the heterogeneity and funnel plots were used to assess publication bias.</p> Results <p>Among 2553 identified studies, 25 were eligible and included in our analysis (<i>N</i> = 3402 patients). The overall bile duct stone clearance rate was 97.0% (95% CI: 95.3–98.5), and single-session bile duct stone clearance rate was 82.7% (95% CI: 76.7–88.1). The overall complications rate was 11.6% (95% CI: 7.3–16.6). Stone clearance rate was 97.2% (95% CI: 88.4–100.0) in patients with abnormal gastrointestinal anatomy, and the rate for stones exceeding a diameter of 15&#xa0;mm was 94.4% (95% CI: 86.2–99.4).</p> Conclusion <p>Percutaneous papillary balloon dilation is a safe and effective treatment for patients with CBDS.</p> Trial registration <p>CRD42024481001.</p>