ERCP is an advanced endoscopic technique that combines endoscopy and fluoroscopy to diagnose and treat biliary and pancreatic duct disorders. A duodenoscope is advanced to the second portion of the duodenum to cannulate the Ampulla of Vater. Contrast injection under fluoroscopy visualizes the ducts and enables interventions such as stone extraction, stent placement, tissue sampling, and leak management. ERCP’s ability to combine diagnosis and therapy in one session makes it an essential tool for precision and efficiency in patient care.