We present a 65-year-old woman with prior left hepatectomy for Intraductal Papillary Neoplasm of the Bile Duct (IPNB), who developed recurrent febrile cholangitis one year later. ERCP revealed an elongated intraductal lesion involving the right hepatic duct and mid-common bile duct. Cholangioscopy was performed for direct visualization and targeted biopsies, showing a papillary lesion extending through the right hepatic duct, common hepatic duct, and upper mid-common bile duct, with a macroscopically visible obstructive nodule. Histology confirmed recurrence of IPNB with high-grade dysplasia. This case highlights the role of cholangioscopy in mapping complex post-hepatectomy biliary lesions, allowing direct visualization, precise tissue sampling, and guiding further therapeutic decisions. Cholangioscopy is increasingly essential in evaluating suspected biliary neoplasms, particularly after prior surgery.