Percutaneous transhepatic cholangiography is a very useful procedure in the diagnosis of jaundice, particularly obstructive jaundice, and other hepatobiliary and pancreatic diseases. It is complementary to endoscopic cholangiography, but is superior to the latter in the diagnosis of proximal lesions in and near the liver. The procedure is very safe, if not absolutely, when performed by experienced personnel with certain precautions. The use of an ultrasound guidance system not only reduces the number of punctures to enter an intrahepatic bile duct, but also prevents puncturing the lung, gallbladder, and portal vein branches, reducing the frequency of complications.