Over the last 5 decades, advances in devices and techniques have enhanced the success of selective biliary cannulation (SBC). “Diagnostic” endoscopic retrograde cholangiopancreatography (ERCP) has been largely replaced by excellent noninvasive imaging modalities and ERCP has now matured into predominantly an interventional procedure. Successful cannulation into the duct of choice is paramount for any ERCP intervention. Endoscopists have realized that successful cannulation does not merely imply access of the desired duct, but accomplishing it in the most efficient and safe manner to minimize complications, especially post-ERCP pancreatitis (PEP).