Cholangiocarcinoma is a type of malignant tumor originating from the epithelial cells of the bile ducts and can be classified into intrahepatic cholangiocarcinoma, hilar cholangiocarcinoma and extrahepatic cholangiocarcinoma according to their anatomical sites. Cholangiocarcinoma is mostly seen in middle-aged and elderly men aged 50-70 years old, and most of them are highly, moderately or poorly differentiated adenocarcinomas, with few other tissue types. Cholangiocarcinoma has a complex etiology, insidious onset, and atypical symptoms, and most patients are already in advanced local stage or have distant metastasis when diagnosed. Its malignancy is high, treatment is difficult and prognosis is very poor. More than 80% of patients die within one year after diagnosis, and the 5-year survival rate is only about 5%. Surgery is the only treatment that can eradicate bile ducts, but it is important to consider whether the tumor invades surrounding blood vessels and lymphatic vessels; in fact, only about 10% of early-stage patients can undergo radical surgical resection. Meanwhile, because of the limited role of radiotherapy in advanced bile duct cancer, palliative chemotherapy is the main treatment modality for locally advanced or distant metastatic bile duct cancer that is inoperable. However, cholangiocarcinoma is not sensitive to chemotherapy and is less sensitive than chemotherapy for other gastrointestinal tract tumors such as colon cancer. However, if administered appropriately, chemotherapy can help relieve symptoms caused by the tumor (such as jaundice and pain) and improve the patient’s quality of life, thereby prolonging survival. In conclusion, for first-line chemotherapy in advanced cholangiocarcinoma, the UK-ABC-02 study is the most complete and largest sample size clinical study to date, showing the survival advantage of gemcitabine combined with cisplatin regimen, which has now become the first-line standard of care for palliative chemotherapy in advanced cholangiocarcinoma. In the selection of chemotherapy regimens, patients’ tumor status, physical status, willingness to treat and tolerance to chemotherapy need to be fully considered, so that the right chemotherapy can be administered to the right patient at the right time to ultimately help patients relieve tumor-induced symptoms (such as jaundice and pain), improve quality of life and prolong survival.