Although the ultlrasonography has been regarded as a main procedure in the diagnosis of bile duct andgallbladder diseases, a few reports concerning the ultrasonographic findings of biliary ascariasis appeared in theliterature. Seven cases of real-time ultrasonographic diagnosis of biliary ascariasis were made in our hospitalduring last 15 months. In six, the diagnosis was confirmed by surgery or radiographic examination. The resultswere as follows; 1. The characteristic long, thick, highly reflective echo without distal acoustic shadowing inthe extra and/or in tra-hepatic ducts were seen in all six proven cases. 2. The echogenic, nonshadowing images ofthe worms were seen as single stripe in five cases(containing a central longitudinal, anechoic tube, suggestingits digestive tract in three cases ) or multiple stripes in one case. But so-called coiled appearance or amorphousfragments were not seen in our cases. 3. Associated findings were as follows; mild to moderate dilatation of theextrahepatic duct in all six duct in 1 case, intrahepatic stone in 1 case, contracted gallbladder containingsingle stone in 1 case and evidence of cholecystitis in 4 cases. 4. One false positive diagnosis of ascariasis inthe gallbladder is considered due to reverberation artefact. No false negative was seen.