Peri-hilar cholangiocarcinoma (PHC) or hilar cholangiocarcinoma (HCCA) characterizes a critical effort to assess significantly sick patients. The existing scenery and proof to the diagnosis and treatments for hilar cholangiocarcinoma are improving day by day. Patients with HCCA encounter numerous obstacles in acquiring efficient therapies. The condition is uncommon, and the majority patients don't have any distinct risk factors, doing selection process inadequate. The initial signs and symptoms

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... in many cases are non-specific, and in many patients the tumors are not resectable because of involvement of the perihilar structures. MRI with MRCP offers further information about the extent of biliary involvement. Furthermore, endoscopic stenting and percutaneous drain could be useful for intricate hilar strictures. Surgical resections with negative margins are related to good likelihood of survival for patients representing with HCCA. Regardless of the accessibility of curative treatment strategies such as operative resection and liver transplantation, most sufferers with HCCA shows with repeated, metastases or locally advanced disease with a poor prognosis. Within this chapter, we have tried to elaborate the modalities of treatment from intervention to surgical approach for HCCA.