Abstract: Bile system disease is common in the digestive system. A large number of studies have shown that changes in the bile microenvironment are closely related to the occurrence of bile system diseases, such as changes in the biliary microecology, changes in bile proteins and metabolites, and the phenotype differences of exosomes in bile, etc. Based on the research advances in common biliary diseases and bile, we will discuss their correlation, and provide authoritative clinical references for further prevention, diagnosis and treatment of biliary diseases.