Percutaneous biliary intervention encompasses diagnostic cholangiography, which is rarely used in isolation now, and therapeutic biliary drainage including percutaneous transhepatic biliary drainage and transhepatic cholecystostomy. With the advantage of being minimally invasive and hence, relatively atraumatic, this technique has made significant foray into management of biliary obstruction (both benign and malignant) and post-surgical biliary complications. This review focuses on the key technical aspects of the procedure along with the commonly anticipated complications that have a significant bearing on the outcome. The authors, thereby, attempt to add their own experience to the existing literature about the various tricky situations that may be encountered during the course of the procedure and tips to circumvent them.