Endoscopic retrograde cholangiopancreatography (ERCP) has been shown to be an accurate and reliable method to evaluate biliary and pancreatic disorders. When an attempt to perform ERCP fails, the managing physician must decide whether to repeat the procedure or rely on other alternatives. We tallied the data from 113 patients referred to our institution for repeat ERCP after a failed attempt at another hospital. This group represented approximately 5% of the total population studied during that period of time. All of the patients had undergone one or more unsuccessful ERCP(s) and were referred to our center for another attempt at ERCP. Using a variety of techniques, we were successful in cannulating the desired duct in 96% of attempts. Pathologic findings were present in 64% of cases, of which 22% were sphincter of Oddi dysfunction. Thus, second attempt ERCP is generally worthwhile if clinically indicated and ERCP expertise is geographically available.