Objective To explore the efficiency and safety of endoscopic retrograde cholangiopancreatography (ERCP) in diagnosis and treatment of children with pancreaticobiliary diseases.Methods A retrospective study was conducted by data collection from 74 children with biliary and pancreatic diseases undergoing ERCP from January 2012 to December 2016 for observation of therapeutic efficacy and postoperative complications.Results A total of 96 ERCPs were performed on 74 patients.The success rate was 94.8％ (91/96) using 29 operating methods.The complication rate of pancreatitis was 10.8％ (8/74),as well as hyperamylasemia was 13.5％ (10/74) and stress hyperglycemia was 10.8％ (8/74).Conclusion The application of ERCP in children with biliary tract and pancreatic diseases is effective and safe.