Abstract: With the progress of research in biliary tract complications after liver transplantation, ischemia-reperfusion injury is attracting more and more attention. However, studies on biliary epithelial cell associatedwith ischemia-reperfusion injury are rarely few. Currently, the clinical diagnosis and treatment of biliary tract diseases causedby bile duct ischemia-reperfusion injury is a tricky one. The pathogenesis of bile duct ischemia-reperfusion injury is various, mainly including: energy metabolismdisorders, microvascular dysfunction causedby organ ischemia, and inflammatory immune response triggeredby reperfusion injury. Therefore, this reviewhighlights the pathophysiology mechanismof bile duct ischemia-reperfusion injury, and discusses examples of imaging diagnosis and innovative therapeutic approaches basedon these mechanistic findings, as well as gains newinsight intothe relationshipbetween ischemia-reperfusion injury and bile duct diseases, in order toprovide valuable information for the clinical diagnosis and treatment of biliary complications after liver transplantation.