This retrospective cohort study analyzed 35 cases of post-cholecystectomy bile duct injuries (BDIs) at Alexandria Main University Hospital from January 2019 to May 2022. The patients were classified using the ATOM classification, and management options were compared based on the timing of diagnosis and the Clavien-Dindo classification. The study found that 45.7% of cases were main bile duct injuries (MBDI), and 54.3% were non-main bile duct injuries (NMBDI). Intraoperative diagnosis was achieved in 28.6% of cases, early postoperative diagnosis in 62.9%, and late postoperative diagnosis in 8.6%. Laparoscopic cholecystectomy (LC) was associated with 84.2% of NMBDI and 18.8% of MBDI, while open cholecystectomy (OC) was associated with 81.3% of MBDI and 15.8% of NMBDI. The Clavien-Dindo classification showed that 68.6% of cases fell into Class IIb, 20% into Class I, 5.7% into Class V (mortality rate), 2.9% into Class IIIa, and 2.9% into Class IV. The study concluded that management options should be individually defined based on the mode of presentation, timing of detection, and type of injury, with early detection and management associated with lower morbidity and mortality. Diagnostic laparoscopy was found to be associated with lower morbidity and better outcomes. The study also emphasized the need for a proper reporting checklist to improve the identification of injury types.This retrospective cohort study analyzed 35 cases of post-cholecystectomy bile duct injuries (BDIs) at Alexandria Main University Hospital from January 2019 to May 2022. The patients were classified using the ATOM classification, and management options were compared based on the timing of diagnosis and the Clavien-Dindo classification. The study found that 45.7% of cases were main bile duct injuries (MBDI), and 54.3% were non-main bile duct injuries (NMBDI). Intraoperative diagnosis was achieved in 28.6% of cases, early postoperative diagnosis in 62.9%, and late postoperative diagnosis in 8.6%. Laparoscopic cholecystectomy (LC) was associated with 84.2% of NMBDI and 18.8% of MBDI, while open cholecystectomy (OC) was associated with 81.3% of MBDI and 15.8% of NMBDI. The Clavien-Dindo classification showed that 68.6% of cases fell into Class IIb, 20% into Class I, 5.7% into Class V (mortality rate), 2.9% into Class IIIa, and 2.9% into Class IV. The study concluded that management options should be individually defined based on the mode of presentation, timing of detection, and type of injury, with early detection and management associated with lower morbidity and mortality. Diagnostic laparoscopy was found to be associated with lower morbidity and better outcomes. The study also emphasized the need for a proper reporting checklist to improve the identification of injury types.