The scope and importance of biliary infections from both a clinical and scientific perspective is rapidly changing. During this past year, considerable attention in the literature has focused on infections that are increasing in frequency in the United States and throughout the world, as a result of evolving demographics and continued spread of the acquired immunodeficiency syndrome epidemic. Pyogenic cholangitis remains a challenge for us to treat and significant controversy remains regarding optimal management. The myriad hepatobiliary manifestations of human immunodeficiency virus infection have led to a resurgence in the interest in parasitic and viral infections. Our understanding of infections and their pathogenesis and sequelae has progressed, although there are still many important questions that remain unanswered.