Abstract: Endoscopic retrograde cholangio-pancreatography (ERCP) has become one of the important methods for diagnosing and treating biliary and pancreatic diseases. Duodenal perforation is the most serious complication after ERCP, which is difficult to manage and has a high mortality rate. In order to standardize clinical management of ERCP and improve patient's outcomes, the Endoscopic Surgery Group of Digestive Endoscopy Branch of Chinese Medical Association, the Endoscopic Surgery Expert Working Group of Chinese College of Surgeons, and the Professional Committee of Pancreatic Disease of Chinese Medical Doctor Association have established an expert group and developed the Guidelines for the management of complications of duodenal perforation associated with ERCP in China (2023 edition) based on the latest evidence. This guideline provides 16 recommendations focusing on the 6 aspects that clinicians are most concerned about, with the aiming to standardize the diagnosis and management of duodenal perforation associated with ERCP in China, and to facilitate its safe popularization.