The authors experienced two patients with biliary tract carcinoma who could not be considered candidates for surgery. One was a 78-year-old female with cholangiocellular carcinoma who presented with acute cholangitis. Tumors had spread to both lobes of the liver, and chemotherapy with gemcitabine (GEM) alone was selected. After three months of treatment, the tumors disappeared radiographically. Disease-free survival has been maintained for 30 months. The second patient was a 79-year-old female with gallbladder carcinoma who presented with acute cholecystitis. Because of her poor cardiac function,GEM single-drug regimen was started. After four months, the tumor had completely disappeared on both computed tomography and ultrasonography. Currently, after 23 months of treatment period, the disease-free survival has persisted. Although GEM was originally applied to non-small cell lung cancer and pancreas cancer, recently, its anti-tumor effect on biliary tract carcinoma has been elucidated, and it is becoming the leader for the first-line regimen. However, the number of patients showing complete remission were still limited.