Abstract: Objective 　To investigate the expression of Survivin and Smac and evaluate whether Survivin and Smac protein play a role in the progression f rom normal epithelium to dysplasia to carcinoma of ext ra2 hepatic biliary t ract . Methods 　The expressions of Survivin and Smac were examined immunohistochemi2 cally in 27 specimens surgically removed ext rahepatic biliary t ract carcinoma, ten cases of dysplasia le2 sions and 5 cases of normal epithelial tissues. Results 　Survivin protein expression was found in 20 of 27 (74. 1 %) invasive carcinoma, 5 of 10 (50 %) dysplasia lesions and 1 of 5 (20 %) normal epithelium. The difference of Survivin expression between invasive carcinoma and normal epithelium was significant ( P =0. 037) . For Smac protein expression, positive rate of expression was 23/ 27 (85. 2 %) in invasive carcino2 ma, 5/ 10 (50 %) in dysplasia lesions and 2/ 5 (40 %) in normal epithelium. The difference of Smac ex2 pression between dysplasia lesions and invasive carcinoma was significant ( P = 0. 041) . There was no sig2 nificance between Survivin expression and histopathological features or clinical stages in invasive carcino2 ma, neither was Smac. Conclusion 　The increased tendency of Survivin and Smac expression in dysplasia2 carcinoma sequence of ext rahepatic biliary t ract indicates Survivin and Smac may be involved in neoplastic development .