Acute obstructive suppurative cholangitis is a potentially lethal complication of biliary tract obstruction, caused by passage of septic material into the circulation originating from pus under tension in the biliary ducts. Of the three cases presented herein, decompression occurred spontaneously in the second one, and was achieved surgically in the other two. The diagnosis is based in Charcot's triad of: Abdominal Pain, Fever and Jaundice, with or without history of biliary disease. Progression leads to septicemia, shock and death. Treatment is surgical and it should be carried out as soon as the diagnosis is made. Effective decompression of the biliary tract is obtained by cannalization of the choledoccus with a T-Tube. Delayed treatment increases mortality, thus the importance of early recognition.