Developments in endoscopic retrograde cholangioscopy provide multiple new advanced methods of biliary imaging. Cholangioscopy provides direct visualization of epithelium with white light as well as advanced modalities, such as narrow band imaging and autofluorescence. In vivo histologic images can be achieved with confocal endomicroscopy. Cross-sectional imaging is also possible with intraductal ultrasonography and optical coherence tomography. This article describes these advanced imaging techniques, which can be used together to assist in the diagnosis of biliary strictures and lesions.