Endoscopic Retrograde Cholangiopancreatography (ERCP) is a specialized procedure in gastroenterology that combines the use of an endoscope and X-ray imaging to diagnose and treat disorders affecting the biliary and pancreatic ducts. Over the years, ERCP has evolved from a diagnostic tool into a critical therapeutic modality for various gastrointestinal conditions. Although initially developed for the management of bile duct stones, ERCP’s applications have expanded to include the diagnosis and treatment of pancreaticobiliary malignancies, strictures, and a variety of other disorders. This article provides an overview of ERCP, its indications, techniques, advancements, risks, and future directions. What is ERCP? ERCP involves the use of a flexible endoscope to visualize the duodenum, bile ducts, and pancreatic ducts. A catheter is passed through the endoscope to inject contrast dye into the ducts, allowing fluoroscopic imaging to detect abnormalities such as blockages, tumors, o...