Pregnancy and its resultant physiologic changes cause the gallbladder volume to double, the emptying rate to slow, and motility impairment, resulting in saturation of cholesterol, which contributes to the ideal environment for gallstone formation. Gallstones can lodge in the common bile duct (CBD) and hence can cause choledocholithiasis. A case of cholelithiasis in the second trimester of pregnancy was complicated by choledocholithiasis and abdominal pain. Treatment was safely achieved using endoscopic retrograde cholangiopancreatography (ERCP), which was done under total intravenous anesthesia (TIVA).