Objective: To compare between one-stage approach Endoscopic Retrograde Cholangio-pancreatography and Laparoscopic Cholecystectomy (ERCP with LC) in the same session, and the current sequential approach (ERCP then LC in separate sessions). Study design: A prospective comparative study. Patients and Methods: 172 patients with the mean age 42 ± 11.8 years presented with combined gall bladder stones and CBD stones, divided into two groups: Group I(80 patients) allowed for one-stage ERCP/LC, and group II(92 patients) allowed for sequential ERCP/LC (LC performed within 7 days after ERCP). Results: The overall success rate to clear the CBD stones and complete LC was 92.5% vs 90.2% respectively. Minor complications in the form of mild post-ERCP pancreatitis, accessory cystic duct leakage and wound infection were observed in five patients in each group in our study (6.25% vs 5.4%),and no deaths were recorded. The mean hospital stay in single-stage ERCP/LC group was 2.8 ± 1.6 (1-12) days, while it was 5.2 ± 1.9 (2-15) days in sequential ERCP/LC group. Single-stage ERCP/LC procedure was more economic than sequential ERCP/LC procedure. The total cost was 10500 ± 1325 Egyptian pounds and 12250 ± 1850 Egyptian pounds respectively. Also, the frequency of anesthetic sessions and anesthetic time exposure was lower in single-stage ERCP/LC group.Conclusion: Both single-stage ERCP/LC and sequential ERCP/LC were safe and effective in detecting and removing common bile duct stones. However, a single surgical procedure for combined gall bladder and common bile duct stones is feasible, cost-effective, and should be available for most patients.