Endoscopic retrograde cholangiopancreatography (ERCP) is a technically demanding procedure and carries one of the highest risks of serious complications. The success and safety of ERCP are strongly influenced by both the experience of the endoscopist and the procedural volume of the centre. Evidence have shown that higher case volumes are associated with improved outcomes and lower complication rates. However, this does not imply that low-volume centres are incapable of performing safe and effective ERCPs. This study aims to evaluate the outcomes of ERCPs performed by a single operator at a district general hospital. The results are compared with recognized international standards to assess the safety and efficacy of ERCP in a lower-volume setting. This retrospective study reviewed ERCP procedures performed in the General Surgery Department of Hospital Pakar Sultanah Fatimah, Muar, between 1 January 2021 and 31 October 2023. Data analysis included patient demographics, cannulation success rates, and procedure-related complications. Patients with missing or incomplete source documentation were excluded. A total of 137 ERCP procedures were analysed, of which 102 were first-time ERCPs. Most patients were Malay females. The overall common bile duct (CBD) cannulation success rate was 93.4%. Stone-related indications accounted for 94 procedures, with successful stone clearance during the first ERCP achieved in 58 cases (59.6%). The incidence of post-ERCP pancreatitis was 10.2%. These findings highlight opportunities for improving the ERCP service. In response, targeted changes have already been implemented to enhance patient safety and procedural outcomes.