We report three cases of biliary tract cancer with positive surgical margin obtained a long-term survival after multimodality therapy. Case 1: A 58-year-old man had operated PPPD for middle part of biliary tract cancer. Final pathological findings revealed HM2. Hepatic metastasis and anastomotic recurrence were observed, postoperatively. RFA and chemoradiation therapy were performed against these lesions. Nevertheless, the patient died of sepsis associated with hepatic abscess caused by cholangitis 5 years and 10 months after surgery. Case 2: A 72-year-old man had operated for upper part of biliary tract cancer. Intra-operative pathological findings revealed HM 2 and DM 2, extra-bile duct resection was performed for this lesion. After surgery, radiation therapy, systemic chemotherapy and hepatic arterial chemotherapy were performed, nevertheless the patient died of cancer 2 years and 6 months after surgery. Case 3: A 75-year-old man had operated for upper part of biliary tract cancer. Intra-operative pathological findings revealed HM 2 and DM 2, an extra-bile duct resection was performed for this lesion. After surgery, chemoradiation therapy, hepatic arterial chemotherapy and systemic chemotherapy were performed, nevertheless the patient died of cancer 3 years and 6 months after surgery.