Objective To explore the application of simulation training in the teaching of percutaneous choledochoscopy lithotomy for advanced physicians. Methods Fifth-six refresher doctors who joined the training program of choledochoscopy from December 2020 to October 2022 in the Department of Hepatobiliary and Pancreatic Surgery of The First Affiliated Hospital of Zhengzhou University were randomly divided into experimental group (n=28) and control group (n=28). The experimental group received simulation training, while the control group received traditional teaching. The theoretical assessment, choledochoscopy skill assessment and questionnaire survey were used to evaluate the teaching effect. Using t-test and χ² test to compare the differences between two groups. Results The theoretical assessment and choledochoscopy skill assessment in the experimental group were higher than that in the control group with (84.32±5.79) vs. (76.71±6.74) and (86.89±7.29) vs. (77.43±6.42), respectively, There were all statistical differences (all P＜0.001). The experimental group had a higher scores than those of the control group in learning interest[(4.68±0.48) vs. (4.32±0.55)], learning efficiency[(4.89±0.32) vs. (4.32±0.48)], self-confidence[(4.57±0.50) vs. (4.25±0.44)], operation ability[(4.75±0.44) vs. (4.07±0.47)], cooperation ability[(4.71±0.46) vs. (3.96±0.43)], rationality of teaching arrangement[(4.75±0.44) vs. (4.25±0.44)] and overall teaching effect[(4.64±0.49) vs. (4.21±0.42)] andThere were all statistical differences (all P＜0.05). Conclusions Simulation training is helpful to improve theoretical knowledge and operational skills of refresher doctors in percutaneous choledochoscopy, and is recognized by these trainees. It is an effective method in the teaching of percutaneous choledochoscopy.