Background: Oriental Cholangiohepatitis (Clonorchis infestation) is caused by Clonorchis sinensis, a liver fluke endemic to China. Objective: To discuss the presentation of clonorchiasis and diagnosis of this condition in the emergency department (ED). Case Report: This is a case report of a Chinese woman who recently immigrated to the United States and was evaluated in a tertiary care urban ED. The patient presented with complaints of abdominal pain and was found on imaging to have clonorchiasis infestation of the bile ducts. She was admitted and treated for cholangitis and clonorchiasis infestation with piperacillin/tazobactam and praziquantel. Conclusion: History and imaging play an important role in diagnosis of this endemic parasitic abdominal infection.