The introduction of microbubble contrast agents (CA), which act as blood pool tracers, has overcome the limitations of conventional B-Mode, colour or power Doppler ultrasound, enabling the display of parenchymal microvasculature. Initially, the use of CA was accepted for hepatic lesions. In the following years, experts have expanded recommendations, as a result of the method's efficiency in extrahepatic applications. In this article we review the methodology and the application of contrast-enhanced ultrasound (CEUS) in the evaluation of biliary pathology. This new imaging tool allows a non invasive differential diagnosis of biliary lesions and a clearer delineation of the tumoral process.