Quincke's triad is a rare presentation of hepatocellular carcinoma (HCC). This case describes the use of endoscopic retrograde cholangiopancreatography (ERCP) and cholangioscopy in the diagnosis of HCC. An 83-year-old man presented with hypotension, right upper quadrant tenderness, and melena. Laboratory tests showed haemoglobin 8.7g/dL and obstructive jaundice. Oesophagogastroduodenoscopy revealed haemobilia. ERCP demonstrated no obvious structure or mass on cholangiogram. Cholangioscopy revealed bleeding from friable, ulcerated mucosa with frond-like projections in the third order of the right intrahepatic ducts. Targeted biopsies obtained and haemostasis achieved by catheter-directed infusion of diluted adrenaline and cold saline. Imaging showed two segment eight lesions with arterial phase enhancement and washout. Histology from the ERCP biopsy confirmed diagnosis of HCC.