Background Risk of choledocolithiasis should be assessed in every patient who must undergo cholecystectomy to define the next step. The American Gastroenterology Society (ASGE) proposed a stratified predictor scale of choledocolithiasis. We aim to describe our experience managing patients with intermediate risk of choledocolithiasis according to the ASGE guidelines and actual presence of bile duct stones in magnetic resonance cholangiopancreatography. Methods A retrospective observational study with a prospective database was conducted. Analysis included socio demographic data, laboratory values and imaging. Bivariate, multivariate and ROC analysis was performed. Results 327 patients had intermediate risk for choledocolithiasis. Half the patients were at least 65 years old. 24.77% were diagnosed with choledocolithiasis. Bile duct dilation was documented in only 3.06% of cases. Diagnosis of choledocolithiasis is associated with age OR: 1.87 (p 0.02), alkaline phosphatase OR: 2.44 (p 0.02) and bile duct dilation 6 mm OR: 14.65 (p 0.00). Conclusions High variability in accuracy of imaging techniques results in a large number of patients classified as intermediate risk without choledocolithiasis in colangioresonance. Therefore, enhancing the criteria to define intermediate risk for patients in order to optimize resources is of paramount importance.