Biliary atresia is a congenital biliary anomaly and is one of the few difficult-to-treat diseases in pediatric surgery. Clinical manifestations are yellowing of the skin and sclera, yellow urine, and white stools of the child after birth, and progressive worsening. The incidence of biliary atresia is not high and is more common in girls. The cause is unknown and may be related to viral infections, such as hepatitis B virus and cytomegalovirus. Early biliary atresia is difficult to distinguish from jaundice diseases such as infantile hepatitis and is usually referred to surgery after a period of ineffective conservative treatment in internal medicine. Biliary atresia can be divided into two types: curable (common bile duct atresia and hepatic duct atresia) and incurable (hepatic portal atresia), which were first reported by Dr. Ladd in the United States in 1928 and first treated successfully by Dr. Kasai in Japan in 1959 with hepatic portal jejunostomy. This was successful. Since then, the Kasai procedure has gradually become the standard procedure for the treatment of biliary atresia and has been widely used. However, the long-term survival rate after Kasai surgery is only 60-70%, and 1/3 of the surviving patients have good quality of life. 2/3 of the patients will develop various complications as they age, such as cirrhosis and gastrointestinal bleeding, which require liver transplantation. However, liver transplantation is not widely performed due to the constraints of liver donation and cost, and some children still have poor outcomes after liver transplantation due to rejection. Biliary atresia should be diagnosed early and treated early. At present, ultrasound, magnetic resonance imaging (MRI) and liver aspiration biopsy are the main means of examination in our hospital. If it is still difficult to clarify, trans-laparoscopic biliary exploration + cholangiography + liver biopsy will be performed. Gussy surgery is best performed within the first 2-3 months of life, as irreversible changes in the liver can occur at too old an age and affect the outcome of the surgery. Parents of children with biliary atresia face a difficult choice: if they choose surgery, the prognosis is poor and they may be left with no money; if they do not operate, they cannot bear to watch their child’s condition deteriorate day by day. It is difficult for doctors to make recommendations, but they can only explain to parents the difficulty of treating this disease and hope that they will make a rational choice according to their family situation and financial status. In general, we hope that parents who have the means to do so will choose surgery to give their children a ray of hope, so that they can be comforted psychologically even if their children are not cured. With the development of medicine, organ transplantation and even artificial liver transplantation will be popular in the near future, and children who fail to undergo surgery will have further opportunities for treatment.