Patients with gallbladder and biliary disease may present with complaints of right upper quadrant or mid-epigastric pain, fever, jaundice, pruritis, nausea, vomiting, or they may be asymptomatic, with only laboratory abnormalities. Ultrasound, multidetector computed tomography (MDCT), and magnetic resonance imaging (MRI) are used for the non-invasive evaluation of patients with signs and symptoms of gallbladder and biliary disease. New MRI techniques, such as functional magnetic resonance cholangiography (MRC), have improved visualization of the bile ducts. In many instances, non-invasive imaging will establish the diagnosis prior to endoscopic, radiological, surgical intervention. The differential diagnosis for these patients is broad and includes infectious, non-infectious inflammatory, neoplastic, and congenital disorders of the liver, gallbladder, and bile ducts. This chapter discusses functional MRI of the bile ducts, including the use of functional MRC, and the patterned approach to the differential diagnosis of gallbladder and bile-duct disease.