PURPOSE Intraductal papillary mucinous neoplasm of the bile ducts (IPMN-B), is the current terminology for a rare mucin secreting tumour, thought to be a precursor to cholangiocarcinoma. Early diagnosis and resection may lead to cure. METHODOLOGY A review of histopathology was added to personal experience, representing several surgeons in Brisbane over a 15-year period. Ethics review was obtained and clinicopathological data and outcomes assessed. RESULTS Of the ten patients who had IPMN-B, 8 were males. Ages ranged from 61-76. Only half of patients who presented complained of pain. All patients had elevated liver function tests (LFTs) and 2 presented with jaundice. Only 3 patients had fluorodeoxyglucose (FDG)-positron emission tomography (PET) scans, and 2 showed avidity. Spyglass cholangioscopy was used diagnostically in 2 patients while preop diagnosis was suspected in 9 patients. All 10 patients underwent surgical resection and in 3 hepaticojejunostomy was necessary. Portal-vein embolization was required prior to surgery in 2 patients. Non-invasive malignancy was evident in 4 patients, 5 patients had invasive cancers while 1 patient had evidence of micro-invasive disease. R0 resection was demonstrated in 9 patients. There was no mortality, however 7 patients suffered complications of varying degree. In the early post-operative period, 2 patients developed cholangitis due to hepaticojejunostomy strictures. No disease recurrence or late mortality has been recorded. CONCLUSION Patients with intrabiliary tumours should be offered surgical resection if possible. Surgical morbidity is significant, but resection can lead to cure.