Percutaneous transhepatic fine calibre cholangioscopy is described. A specially developed transparent instrument is used, which makes it unnecessary to have a steerable endoscope; visualisation of the biliary tree is of diagnostic value for assessing biliary stenoses due to tumours (choice of biopsy site, extent of intraductal radiation therapy) and for the assessment of anastomoses between the biliary system and the gut (condition of the mucosa, stenoses). In the presence of percutaneous biliary drainage, the method has little utility. Extension of the method for treating intraductal stones may be possible if in future a useful lumen can be added to the fine endoscope.