Objective: To investigate the causes, management and prevention measures of iatrogenic bile duct injury (IBDI). Methods: The clinical data of 56 patients with IBDI after operation from January 2004 to September 2010 were retrospectively analyzed. Results: Among the 56 patients, IBDI of 36 (64.3%) cases resulted from laparoscopic cholecystectomy, 12 (21.4%) cases from open cholecystectomy, 5 (8.9%) cases from common bile duct exploration and 3 (5.4%) cases from radical gastrectomy; 33 cases were discovered during operation and the other 23 cases were found after operation. Surgical treatments for IBDI included primary bile duct repair or reconstruction, bilioenteric anastomosis and biliary stenting. Postoperative follow-up showed that 50 (89.3%) patients obtained a favorable outcome, while 6 patients had poor results, 3 of whom developed postoperative biliary stricture or intrahepatic bile duct stones, and the other 3 cases died due to liver failure or septic shock. Conclusion: The causes of IBDI are associated with the local anatomic variations in bile ducts of the patients, pathological factors and surgical skills of the surgeon. IBDI requires individualized treatment depending on a number of factors such as the causes, detection time, severity and location of injury, as well as the extent of biliary stricture and general conditions of the patients.