Objective To retrospectively analyze the efficacy and toxicity of unresectable hilar cholangiocarcinoma treated with concurrent capecitabine and radiation therapy. Methods Nineteen patients with unresectable hilar cholangiocarcinoma underwent concurrent chemo-radiotherapy protocol from May 2005 through March 2012. All patients received three-dimensional conformal radiotherapy (3D-CRT), 5 times a week at 2 Gy per fraction per day to a total dose of 50 Gy. Concurrent chronomodulated capecitabine was administered on days of irradiation in a dosage of 1 g in the morning and 2 g in the evening. Results All patients completed the treatment course. Twelve patients(63.2%)achieved a PR, and seven (36.8%) achieved a SD at the first follow-up examination. The median survival time was 12.7 months (range 4.3 to 20.8 months) and the median disease-free survival time was 9.3 months (range 3.6 to 18.6 months). A cumulative grade 3 toxicity was observed in 3 out of the 19 patients (15.8%). No patient had any grade 4 toxicity. Conclusions Concurrent capecitabine and radiation therapy is effective and tolerable in patients with unresectable hilar cholangiocarcinoma.