Choledochal cysts are uncommon in Zambia, but are frequently misdiagnosed and consequently mistreated. It is recommended that anastomotic drainage of the cyst into the duodenum or jejunum should be done as a first stage procedure on severely sick patients seen in rural hospitals, prior to their transfer to major hospitals where definitive procedure such as end to end anastomosis of the common bile duct or Roux-en Y choledochojejunostomy can be performed. Our experience of five cases seen over seven years is reported.