Acute cholangitis is an acute inflammation and infection in the bile duct mainly due to calculous obstruction. Its clinical presentation is the Charcot's triad "pain of the right upper quadrant, fever, jaundice" appearing within 1 or 2 days. The anatomical diagnosis is made by ultra sonography or MRI cholangiography. Patients have to be admitted in ICU for an urgent treatment of the sepsis, the drainage of the infected bile and the removal of the obstruction. Endoscopy and interventional radiology have completely modified the management in diagnostic and treatment strategies, and laparoscopic surgery has modified the surgical approach for the systematic cholecystectomy and the main bile duct exploration. It is important to recognise the occurrence of an acute pancreatitis, a potentially severe related condition.