Recurrent pyogenic choliangitis is a disease occurring in oriental persons characterized by intrahepatic pigment stone formation with recurrent exacerbation and remissions of abdominal pain associated with jaundice, chills and fever. Authors retrospectively analysed endoscopic retrograde cholangiograms in 53 patients with recurrent pyogenic cholangitis, diagnosed by surgery(n-33) or on the clinical basis9n=200. Cholangiographic findings of recurrent pyogenic cholangitis were disproportionately severe dilation of the extrahepatic ducts with mild or no dilatation of the intrahepatic ducts, filling defect by a stone or stones(n=45), straightening and rigidity of the intrahepatic ducts(n=33), increased or right angle bile duct branching pattern(n=31), decrease in arborization(n=14). I 47 cases of recurrent pyogenic cholangitis with stone, stones were in the extrahepatic ducts in 27 cases, intrahepatic ducts in 5 cases, and both intra-and extrahepatic ducts in 15 cases. In 6 cases, there were no stones in the bile ducts; in these cases, characterisic cholangigraphic findings enabled us to diagnose recurrent pyogenic cholangitis. , endoscopic retrograde cholangiogram is the modality of choice in diagnosing recurrent pyogenic cholangitis, especially in the absence fo stones o ultrasound examination.