Klatskin tumors, or hilar cholangiocarcinomas, are an uncommon cause of obstructive jaundice. With the advent of sophisticated imaging studies and cholangiography, these tumors can be preoperatively identified in most patients, and a treatment plan can be outlined before operative exploration. Surgical resection of the hepatic bifurcation with the addition of a hepatic lobectomy as indicated by tumor extension is the treatment of choice. Although complete surgical resection improves survival over that achieved with palliative procedures, the 5-year survival rate remains less than 20%. Postoperative radiation therapy may increase long-term survival.