Introduction:   Diseases of gall bladder and biliary tree are common. Ultrasonography (USG) is used as primary modality for diagnosing hepatobiliary and pancreatic diseases; but complete hepatobiliary evaluation requires good acoustic window and lack of gas in overlying bowel. Magnetic Resonance Cholangio–Pancreatography  (MRCP)  is considered excellent modality for extra–hepatic biliary tree and pancreatic duct (MPD)  evaluation.

Aims: Aims were to compare MRCP and USG findings in cholangio–pancreatic diseases and to measure and compare diameters of extra–hepatic bile ducts and main pancreatic duct on MRCP and USG with same fasting status on same day.

Study Design:  This was prospective cross sectional analytical study.

Material and Methods:  During two and a half years of study, 33 patients referred for MRCP and USG to Radiodiagnosis Department of Shree Krishna Hospital, Karamsad and done on same day were included in this study. Clinical history and laboratory tests were collected. MRCP  and  USG were done with same fasting status and their  observations were compared.

Results: Statistical analysis for sensitivity and specificity of Ultrasound was done. Right, left & main hepatic ducts, common bile ducts (CBD) and MPD diameters were measured by MRCP & Ultrasound; which were compared by Bland–Altman method for statistical agreement.

Conclusion:  Sensitivity and specificity of USG as compared to MRCP in diagnosing cholangio–pancreatic disorders were 75.61% and 100% respectively. Excellent agreement was found in the measurements of extra–hepatic biliary tree and MPD diameters with  <  1.0 mm variation.