Objective To investigate the effects and safety of needle?knife precut papillotomy in diffi?cult common bile duct cannulation of endoscopic retrograde pancreatic duct radiography ( ERCP ) . Methods The data of 104 cases treated with needle?knife precut papillotomy were retrospectively analyzed. The effect of pre incision and short?term complications were observed,and compared with 1326 cases( conventional group) of con?ventional selective intubation in the same period of ERCP. Results Successful cannulation of the bile duct was achieved in 97 of 104 patients who underwent needle?knife precut papillotomy, the total success rate was a?chieved in 93. 3%. The complications of needle?knife precut papillotomy occurred in 8 patients(7. 7%),inclu?ding mild bleeding in 4 cases,mild pancreatitis in 2 cases and billiary infection in 2 cases. There were 1326 ca?ses conventional selective intubation in the same period of ERCP,and 98 cases(7. 4%) with complication. There was no significant difference in the incidence of complications between the needle knife cut group and the con?ventional selective intubation group(χ2=0. 055,P>0. 05 ) . Conclusion In case of difficult common bile duct cannulation of ERCP,needle?knife precut sphincterotomy surgery can be safely and effectively catch the high ?ERCP the success of treatment,is worthy of wider application.