Biliary tumors are associated with a high morbidity and mortality rate. Majority of these tumors include gallbladder adenocarcinoma and cholangiocarcinoma (CCA). Even with recent advances in medical imaging, most of these tumors are often diagnosed at advanced stages. The radiological imaging consists of computed tomography (CT) scan, magnetic resonance imaging (MRI), magnetic resonance cholangiopancreatography (MRCP), and CT/positron emission tomography (PET) for characterizing these tumors. Endoscopy based imaging technology includes endoscopic retrograde cholangiopancreato­gram (ERCP), peroral cholangioscopy (POCS), endoscopic ultrasonography (EUS), intraductal ultrasonography (IDUS), confocal laser endomicroscopy (CLE), and optical coherence tomography (OCT). Endoscopy also provides therapeutic options, including endoscopic stenting, intraluminal high dose brachytherapy, and photodynamic therapy. This chapter discusses in depth regarding diagnostic modalities and therapeutic options in patients with biliary tumors.