Objective: To explore the value of color Doppler ultrasonography for assessing early forecast of biliary complications after liver transplantation by examing hemodynamic changes. Methods: Total 156 patients after liver transplantation were examined by color Doppler flow imaging(CDFI). Following results were obtained including hepatic arterial peak systolic velocity (PSV) and resistance index(RI),portal venous maximum velocity(PVV) as well as hepatic venous Doppler wave pattern. The process of hemodynamic changes was analyzed retrospectively. Thirty patients with biliary complication after liver transplantation were compared with 40 without any other complications control group. Results: ① Hepatic arterial PSV was lower within postoperative 30 days and hepatic arterial RI was higher within 15 days than those of the control group (P < 0.05). ② Twenty-two patients of 30 with biliary complication were diagnosed to have clinically relevant acute rejection(AR). From postoperative day 6 to 14,the serial change of decreasing PVV was significantly greater in patients with clinically relevant AR than that of the control group(P < 0.05). ③ The changes of hepatic venous flow pattern from triphasic to two-phase or monophasic were observed in patient with acute rejection. Conclusion: Hemodynamic changes examined by CDFI have the feasibility to predict biliary complication after liver transplantation resulting from poor hepatic artery blood supply,acute rejection and ischemia-reperfusion injury.