Carcinomatous meningitis is clinically less common than brain metastasis or spinal cord compression, but has dire consequences for both the quality of life and the overall survival of patients with various kinds of malignancies. It occurs in about 5% of all adult cancer patients, though autopsies may double this number. The primary tumors that frequently cause carcinomatous meningitis include lung cancer, breast cancer, leukemia, lymphoma, and melanoma. Carcinomatous meningitis secondary to primary tumors in the gastrointestinal tract is clinically infrequent. In this report, we describe a 73-year-old man with lower bile duct cancer, who developed carcinomatous meningitis following surgical resection of the primary cancer. To our knowledge, this is the third case of carcinomatous meningitis secondary to cholangiocarcinoma described in the literature so far.