Abstract: ［Abstract］Objective　To explore the use of CA199， CEA， CA50 and ALP combined with magnetic resonance imaging （MRI） in diagnosis of intrahepatic bile duct stones with early bile duct carcinoma. Methods　The clinical diagnosis of 36 cases of patients with hepatolithasis-associated intrahepatic cholangiocarcinoma （HICC） and 118 cases with intrahepatic duct stone（IHDS）were analyzed retrospectively. Serum CA199， CEA，CA50，ALP and magnetic resonance（MRI，MRCP）were performed and the results were analyzed. Results Abdominal pain discomfort in Hepatolithasis-associated intrahepatic cholangiocarcinoma showed multiple symptoms．Three typical Charcot syndromes were rare．On the gender distribution，intrahepatic bile duct stones was frequently found in women，on the contrary，Hepatolithasis-associated intrahepatic cholangiocarcinoma was frequently more found in men（P＜0.05）．Abdominal pain and fever in patients of Hepatolithasis-associated intrahepatic cholangiocarcinoma was more than that of patients with Intrahepatic bile duct stone（P＜0.05）．When alkaline phosphatase（ALP）was more than 169 U/L，significant difference was seen between two groups（P＜0.05）．According to the diagnosis of HICC，the accuracy of CA199，CEA，CA50 combined with ALP was 88.6%，the accuracy of magnetic resonance examination alone was 90.2%，and the accuracy of multiple serological markers and magnetic resonance was 95.5%. Conclusion　MRI combined with serum CA199，CEA，CA50 and ALP can effectively improve the HICC preoperative diagnosis rate.