Abstract: Recent studies demonstrated that metabolism plays an important role in the pathogenesis,clinical diagnosis,and treatment of intrahepatic cholangiocarcinoma (ICC).The mechanisms of several metabolic enzymes associated with ICC,including pyruvate kinase M2 (PKM2),thymidine synthase (TS),thymidine phosphorylase (TP),dihydropyrimidine dehydrogenase (DPD),isocitric acid dehydrogenase 1/2 (IDH1/2),and cyclo-oxygenase-2 (COX-2),have been gradually clarified and hopefully transformed into clinical application in the future.Besides,ICC patients always have concomitant abnormal lipid metabolism,which has attracted the attention of clinicians and researchers.Metabolites in serum and bile have potential diagnostic utility,which has yet to be verified by prospective clinical research.18F-FDG PET/CT based on metabolism presents application value in many aspects of ICC,such as diagnosis,staging,evaluation of therapeutic effect,and monitoring prognosis.In this article,we review the recent progress in the understanding of the role of metabolism in ICC from both basic and clinical perspectives,with an aim to highlight the further research directions and accelerate the clinical transformation.