Abstract: Objective To study the application of endoscopic retrograde cholangiopancreatography(ERCP) in diagnosis and treatment of biliary and pancreatic diseases. Methods Clinical data about 1 378 patients diagnosed and treated in our department from September 2003 to February 2011 were retrospectively analyzed. Results The number of patients who underwent therapeutic ERCP increased from 13(13.6%) in 2003 to 236(86.7%) in 2011.The success rate of radiography was 93.32% in the 1 378 patients.Of these patients,693 received therapeutic ERCP,accounting for 50.29% of the total ERCP times.Bleeding occurred in 4.09% of the patients during ERCP and pancreatitis occurred in 8.54% of the patients after ERCP. Conclusion ERSP is an important procedure for the diagnosis and treatment of biliary and pancreatic diseases as well as complications after liver transplantation,especially for those with malignant bile duct obstruction who have lost their chance of operation,and can prolong their life and improve their quality of life.