Purpose/Introduction: To analyse the incidence, diagnostic modalities and intervention outcomes of post-cholecystectomy bile leaks (PCBL) at our regional centre. Methodology: A retrospective database search was conducted to identify PCBL cases from July 2014 to June 2024 at Coffs Harbour Health Campus. Descriptive statistics were used to summarise clinical characteristics, and chi-square tests were performed to assess potential associations. Results: 15 PCBLs were identified amongst 1888 cholecystectomies (0.79%). The mean age of PCBL patients was 61.7 ± 13.5 years. Most occurred in females (80%) and in the emergency setting (66.7%). There was a significant association between open cholecystectomy and higher PCBL rates (χ² = 83.68, p < 0.00001), with PCBLs occurring in 12.2% (6/49) of open cholecystectomies. PCBLs were primarily diagnosed via drain output (80%), and most were Strasberg Type A (73.3%). ERCP was performed in 73.3% (11/15) of cases (mean time to ERCP: 7.4 days), while drainage occurred in 53.3% (8/15) of cases (mean time to drainage: 2.8 days). 27.3% (3/11) were transferred out to a tertiary centre for ERCP and had a longer mean cumulative length of stay (LOS) compared to locally managed ERCP patients (20.3 vs. 9.0 days). Emergency patients had a longer mean cumulative LOS than elective patients (17.5 vs. 9.4 days). Conclusions: The incidence of PCBL was significantly higher in open cholecystectomies compared to laparoscopic. Most bile leaks were low-grade, diagnosed clinically, and managed with ERCP with or without drainage. Delays associated with ERCP transfers were linked to prolonged hospital stays, as were emergency presentations, underscoring the need for increased local ERCP access.