Objective To explore the clinical efficacy of endoscopic biliary metallic stent drainage( EBMSD) in the treatment of malignant obstructive jaundice( MOJ). Methods A total of 48 patients with MOJ who underwent EBMSD in the General Hospital of Beijing Military Command from January 2012 to April 2014 were included in the study. Liver function parameters,including alanine aminotransferase( ALT),aspartate aminotransferase( AST),alkaline phosphatase( ALP),total bilirubin( TBil),direct bilirubin( DBil),and glutamyl transpeptidase( GGT),were compared before and after treatment. Comparison of continuous data was made by t test. Results Placement of the stent was successfully performed in 44( 91. 67%) of the 48 patients; single- stent drainage was performed in 34 cases,and double-stent drainage in 10 cases. The patients had significantly reduced levels of TBil,DBil,ALT,AST,ALP,and GGT after EBMSD( all P <0. 01); the patients treated by double- stent drainage had significantly more improvements in these liver function indices than those treated by single- stent drainage( all P < 0. 01). Thirty- eight cases were successfully followed up after operation,and the 3- and 6- month survival rates of these patients were 94. 25% and 73. 39%,respectively. Conclusion EBMSD has remarkable efficacy in the treatment of MOJ. This operation can effectively relieve jaundice and improve quality of life in MOJ patients,and double- stent drainage is superior to single- stent drainage.