Liver transplantation (LT) carries the risks of postoperative biliary complications, contributing substantially to morbidity. Endoscopic retrograde cholangiopancreatography (ERCP) has emerged as a minimally invasive, highly effective first-line intervention for managing these complications. This chapter highlights the critical role of interventional endoscopy in post-transplant care, focusing on indications such as biliary strictures, leaks, choledocholithiasis, and sphincter dysfunction. Additionally, we discuss procedural considerations, technical challenges unique to transplant anatomy, complication management strategies, and the future directions of advanced endoscopic techniques in liver transplant patients.