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Objective: To evaluate whether preoperative Endoscopic Retrograde Cholangio-Pancreatography (ERCP) with sphincterotomy increases the risk of surgical site infections following laparoscopic cholecystectomy. Design: Retrospective study (2010-2016). Setting: Academic hospital. Patients: Patients who were older than 18 and had a laparoscopic or a laparoscopic converted to open cholecystectomy for complicated biliary tract disease (choledocholethiasis, cholangitis, acute cholecystitis, or gallstone pancreatitis) were included. We compared those who had a preoperative ERCP with sphincterotomy to those who did not. Stepwise logistic regression was used to identify independent predictors of surgical site infections. Main Outcome Measure: The rate of surgical site infections in patients with and without preoperative ERCP. Results: A total of 640 patients were included. Of them, 122 (19.1%) received preoperative ERCP and 518 (80.9%) did not. The ERCP patients were older (median age 59 versus 46, p<0.001) and more frequently males (54.1% versus 36.7%, p<0.001). Their preoperative diagnoses were also different compared to non-ERCP patients (choledocholethiasis [35.2% versus 7.0%], acute cholecystitis [31.2% versus 76.4%], gallstone pancreatitis [20.5% versus 16.2%], and cholangitis [13.1% versus 0.4%], p<0.001). The rate of surgical site infections was higher in the preoperative ERCP patients (11.5% versus 4.0%, p=0.005) and their hospital length of stay was longer (median of 4 versus 3 days, p<0.001). In the multivariable analysis, conversion to open (odds ratio=2.57, 95% confidence interval=1.06-6.21, p=0.037) and preoperative ERCP (odds ratio=3.12, 95% confidence interval=1.34-7.22, p=0.008) were the only independent predictors of surgical site infections. Conclusions: Preoperative ERCP increases the risk of surgical site infections threefold in patients undergoing laparoscopic cholecystectomy for complicated biliary tract disease.