Abstract: Thispaper presents 218 cases of malignant obstructive jaundice admitted in our hospital during the period of 1978-1996. Before 1990, their diagnses mainly depend on B-us and PCT.From then on, PCT was used in cases with cholangioectasis B-us; While ERCPT wasused in Patients without cholangioectasis. In individual cases, CT、ECP、MRI were used for com-plement and confirmaton. In this series, the rate of pre-operative definite diagnoses got to 86.6%, the incicive rate got to 53.76% and the five-years living rate was rased to 50%.