Mohamed Serag El-ERCP has evolved from a diagnostic to a therapeutic maneuver allowing treatment option for many pancreatobiliary lesions. In this study we assessed the role of ERCP in the management of suspected hepatobiliary and pancreatic diseases presenting to the Endoscopy Unit of Kasr EL-Aini Hospital, Cairo University. Patients and Methods: We retrieved the data of 2384 patients who were referred for ERCP within the years 1999, 2000 and 2001(Group I).Further 30 patients were included in the study (Group II). The latter group were subjected to the following: history, clinical examination, biochemical tests, abdominal ultrasonography, available abdominal CT and ERCP.Results :Commonest indication for ERCP was biliary stones in both groups, followed by CBD strictures either of apparently benign or malignant lesion. Normal findings at ERCP was rare. Most patients were subjected to therapeutic interventions in group I (78%) and group II (93%).Failure rate at cannulation was (8%) in group I and (3%) in group II. Conclusion :ERCP has become a corner stone in the management of pancreato-biliary disorders, not only for diagnostic purposes but with a variety of treatment options. Results from our center are quite similar to those published in the inter-national literature