Objective To summarize computed tomography (CT) and magnetic resonance (MR) imaging features of multiple bile duct hamartomas (BDH) and analysis changes of lesions with concurrent infection before and after treatment on MRI and CT to improve understanding of the imaging findings of the disease. Methods This retrospective study reviewed CT and MR imaging findings of ten patients with multiple bile duct hamartomas in our hospital and compared the difference of imaging findings before and after therapy in those with infection. Results Non-contrasted enhanced CT images of multiple bile duct hamartomas showed scattered or diffuse low density lesions with no enhancement; T2 weighted imaging (T2WI) was sensitivity to detect cystic lesion with significantly higher signal. Diffuse liver disease could be well displayed by Magnetic Resonance Cholangiopancreatography (MRCP), and all lesions were without intrahepatic biliary communication and have irregular borders when concurrent infection. Conclusion CT examination is limited in the diagnosis of biliary hamartomas, and conventional noncontrasted MRI and MRCP examinations have great value and show some advantages in the diagnosis of multiple bile duct hamartomas compared to CT, while we should pay more attention to the change of imaging findings of those with concurrent infection.