Clonorchiasis is a parasitic disease that is often found in Japan, Korea, China, Hong Kong as well as in countries in Southeast Asia. The disease is caused by the ingestion of infected raw freshwater fish. The clinical manifestations depend on the number of flukes in a patient, the period of infestation, and the complications. In patients with a heavy infestation, extrahepatic bile duct, the gallbladder and even the pancreas are involved. We experienced a 62-year-old man who had a history of ingestion of raw freshwater fish and presented with acute pancreatitis and cholangitis. The pancreaticobiliary-associated clonorchiasis was successfully treated with endoscopic sphincterotomy, and praziquantel. (Korean J Gastrointest Endosc 2006;32:231234)