Cholangiocarcinoma, the typical bile duct epithelium neoplasm, is most commonly reported in the Northeast ofThailand. Surgical intervention is the only possible curative treatment in the early stage of disease. Unfortunately,most patients are advanced at the time of diagnosis and not appropriate for curative surgical treatment. Theprognosis of advanced CCA is extremely poor and chemotherapy is the only approved treatment for this stage ofdisease. This article reviews the state-of-art chemotherapy for locally advanced or metastatic cholangiocarcinoma.