Focal intrahepatic strictures (FIHS) refers to local strictures or stenosis of the intrahepatic bile duct induced by various factors. FIHS is easily leading to misdiagnosis and miss diagnosis. At present, most of the techniques or examinations for making position as well as qualitative diagnosis of FIHS have poor sensitivity. Paying more attention to the medical history and combined applications of various inspection methods might help to improve the diagnostic level of FIHS. In terms of treatment, we suggested for patients with suspected malignant strictures or those who were failure of medical treatment, dilation, drainage and pathological diagnosis of FIHS could be conducted by endoscopy before determining the indications and procedures of surgery based on a new anatomy classification system of FIHS.