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Bile duct cysts are an uncommon condition that may cause significant morbidity and are considered a risk factor for hepatobiliary malignancy. Standard treatment is resection and has traditionally been performed using an “open” laparotomy incision. Laparoscopic resection and reconstruction is feasible and safe as reported in the existing literature in small series. A minimally invasive approach requires experience in both hepatobiliary surgery and advanced laparoscopic skills. This video presents a 43 year-old female who presented with a symptomatic Type IV bile duct cyst and demonstrates the key technical aspects of extrahepatic bile duct resection with Roux-en-Y reconstruction.