Cholangiocarcinoma (CCA) is a major public health problem in the northeastern part of Thailand where the prevalence of this cancer is highest in the world. It is a slow growing tumor but highly metastatic with a poor prognosis. The traditional habit of eating raw fish, repeated exposure to liver fluke and consumption of nitrosamine-contaminated food are major risk factors. Understanding of carcinogenesis and metastasis of cholangiocarcinoma at the molecular level will provide tools for better prevention, diagnosis and treatment. This review focuses on CCA- associated genes and their possible applications.