With the improvement of endoscopy and ultrasound imaging technology, endoscopic ultrasound has not only been used as an important endoscopic examining method, but also developed for minimally invasive interventional treatment of adjacent tissues and organs. At present, endoscopic ultrasound guided interventional therapy has become an optional treatment for several biliary and pancreatic diseases. In this paper, we make interpretation and comment on European Society of Gastrointestinal Endoscopy (ESGE) Therapeutic endoscopic ultrasound Guideline, 2021., aiming to clarify the applicable conditions, technical methods and therapeutic effect differences of therapeutic endoscopic ultrasonography, including EUS-BD, EUS-PD, EUS-GBD and EUS-GE, and to provide guidance for clinicians.