This paper describes the management of 12 cases of biliary ascariasis at the Chittagong Medical College & Hospital, Chittagong, Bangladesh. The diagnosis may be done clinically or on the basis of mere suspicion if sophisticated investigations like ultrasonography scanning etc. are not available. Laparotomy and exploration of the bile duct is essential as the condition does not improve by conservative treatment. The Ascaris Lumbricoides can be removed by strong suction from the bile duct. Retained Ascaris can be expelled from the bile duct by anti-spasmodic drug for the relaxation of the sphincter of oddi and by hydrostatic pressure in the bile duct by infusion of normal saline solution through the T-tube.