Background: Bile duct injury following blunt abdominal trauma is a rare entity that can occur without associated hepatic or intraabdominal injury. Diagnosis is often delayed; hence clinical suspicion needs to remain high for patients with unexplained abnormal LFTs or abdominal pain. There is minimal evidence to guide appropriate management of traumatic bile duct injuries although ERCP with stenting has been described. Clinical Case: A 48-year-old female presented following a fall off a cliff with a past medical history significant for previous laparoscopic cholecystectomy. She was intubated at the scene for agitation. Her initial CT demonstrated fatty stranding around the liver hilum. She subsequently developed pseudo-obstruction requiring decompression, and severe ARDS, requiring ECMO. She developed worsening ascites during her admission. An ascitic tap revealed frank bilious ascites, and she proceeded to ERCP. This demonstrated retrograde contrast leak from the residual cystic duct. This was managed with the insertion of a double pigtail stent into the CBD. She was discharged home after an 80-day admission and repeat ERCP a month after discharge showed resolution of the bile leak allowing for stent removal. Conclusion: Isolated extrahepatic bile duct injury is a rare clinical entity causing significant morbidity that requires a high index of suspicion to allow for timely diagnosis. Pereira, R., Vo, T., & Slater, K. (2019). Extrahepatic bile duct injury in blunt trauma: A systematic review. J Trauma Acute Care Surg, 86(5), 896-901. Sharma, B., Mishra, S., Kumar, R., & Sarin, S. (2009). Endoscopic management of bile leaks after blunt abdominal trauma. Journal of Gastroenterology and Hepatology, 24(5), 757-761.