Diagnostic imaging plays a key role in the management of diseases of the bile ducts and gallbladder. Although ultrasonography (US) remains the first-line imaging modality for suspected biliary obstruction and even the standard of reference for cholecystolithiasis, it is mainly computed tomography (CT) and, even more, magnetic resonance (MR) imaging that have replaced invasive diagnostic procedures such as endoscopic retrograde cholangiography (ERCP) and percutaneous retrograde cholangiography (PTC) in the majority of diagnostic settings. The different noninvasive and invasive imaging modalities often provide similar or complementary diagnostic information, so the choice of the most appropriate imaging modality for a given indication is often influenced by a variety of factors, including individual patient characteristics, local preferences, local availability, and economic aspects.