Objective To evaluate the value of ERCP in treating hepatocellular carcinoma complicated with tumor thrombi in bile duct.Methods To analyze retrospectively the results of 15 cases of hepatocellular carcinoma with tumor thrombi in the bile duct including ERBD 8 cases and ENBD 7cases,EMBE after ENBD 4 cases, EST with clearance of tumor thrombi and cytological brush 12 cases, ERCP conjugated with other compositive treatments 9 cases.Results The common feature of cholangiography is filling defect in the bile duct as the so called "tennis bat" sign and "flocculation" sign, 13 cases have got drainage successfully after ERCP with the effective rate 86 7%, Satisfactory results were obtained in patients received ERCP conjugated with other compositive treatments.Conclusion ERCP is very important treatment of hepatocellular carcinoma with tumor thrombi in the bile duct; the "tennis bat" sign and "flocculation" sign were the very important evidences of tumor thrombi in the bile duct. If combined with other compositive treatment such as surgery and TAE, ERCP is very effective treatment for the releasing symptoms, improving living quality and prolonging life span in these patients, even in some patients radical cure could be obtained.