40 cases of bile duct carcinoma gathered over a 6-year period at Kosin Medical College were reviewed and their clinical and cholangiographic findings were as follows : 1. There were 29 males and 11 females(the ratio of men to women,2.6 :1) ranging from 37 to 74 years of age. The majority (70 % of cases) were in 4 th & 5th decades. 2. Clinical symptoms and signs : jaundice in 95%, RUQ or epigastric pain in 75% , pruritus in 52.5%, dark urine in 35% weight loss in 32.5%, fever and chills in 22.5%, clay colored stool in 12.5%, and palpable mass in 12.5%. 3. Lab. findings : elevated serum total bilirubin (above 20.0mg% in 45%. 10.0-19.9mg% in 22.5%, 5.0-9.9mg% in 20 %, 1.3-4.9%mg% in 5%), elevated alkaline phospatase in 95%. Clonorchiasis were noted in 17.5%. 4. Histologic findings were adenocarcinoma in most cases. 5. The location of bile duct carcinoma were common hepatic duct in 35%, common bile duct in 32.5%, porta hepatis in 12.5%, junction with cystic duct in 10% and diffuse form in 10%. 6. In 33 cases, PTC or post-operative cholangiographic examination were done. And the most frequent findings were dilation of the proximal bile duct and abrupt narrowing or complete obstruction of distal lumen. In 27 cases(82%), complete obstruction of bile duct was noted. Attempts were made to analyze the type of obstruction : Constricted type in 39 %, Nipple type in 18%, round or flat type(smooth or slightly irregular) in 15%, and serrated type in 9%). Incomplete obstruction were noted in 6 cases (18 %) . Among them, abrupt narrowing of Lumen was noted in 9% and diffuse narrowing in 9%. 7. ERCP was done in 7 cases. Findings were : constricted type in 42.6% , constricted and slightly irregular type in 14.3%. downward convexity in 14.3%, diffuse irregular narrowing in 14.3% and intraluminal filling defect in 14.3%.