Abstract: Objective To investigate clinical effect of endoscopic retrograde cholangiopancreatography and percutaneous transhepatic biliary drainage for treatment of malignant obstructive jaundice,to provide a reference for clinical treatment. Methods One hundred and forty cases of malignant obstructive jaundice patients were selected,divided into ERCP group and PTCD group according to the surgical treatment .The surgical success rate,jaundice remission rate,complications,treatment costs and clinical indicators were compared. Results In ERCP group and PTCD group,the low obstruction and high obstruction success rates were 94.74% vs. 71.43%，84.21% vs. 100.00%,the differences were statistically significant(P＜0.05);the low and high obstruction obstructive jaundice remission rates were 98.25% vs. 78.57%，68.42% vs. 92.00%,the differences were statistically significant(P＜0.05);after two weeks,two groups of patients were significantly improved.The difference was statistically significant(P＜0.05).In ERCP group and PTCD group,the overall complication rate was 5.26% vs 17.19%,contrast significantly(P＜0.05),in ERCP group and PTCD group with low obstruction complication rates were 1.75 % vs. 28.57%, the differences were statistically significant (P<0.05);in ERCP group and PTCD group,length of stay,cost of surgery,treatment cost were (13.54±2.54) d vs. (20.14±3.38) d,(2.62±0.15)×10 000 Yuan vs (2.15±0.41)×10 000 Yuan,(4.82±0.69) vs. (5.04±0.71)×10 000 Yuan, the difference was statistically significant(P＜0.05). Conclusion ERCP and PTCD treatment both has good effect for malignant obstructive jaundice,for low obstruction ERCP treatment should be preferred,for high obstruction PTCD treatment should be preferred.