Abstract: Objective To evalate the clinical effects of anterograde and retrograde palliative biliary drainage given to the patients suffer from obstructive jaundice caused by advanced hilar cholangiocarcinoma. Method Retrospective analysis was performed on 113 patients’ clinical information in our hospital who suffer from advanced hilar cholangiocarcinoma form 2005 to 2015. Comparison between the two groups in terms of effect of biliary drainage,hospital stays, postoperative feeding time, hospital cost and survival time during perioperation stage,postoperative complication was compared. Results Postoperative feeding time and postoperative complication in group under anterograde and retrograde palliative biliary drainage was less than in group under retrograde biliary drainage （P<0.05）. The incidence rate of biliary infection and pancreatitis were superoir to those in retrograde biliary drainage group （P<0.05）. Conclusion Anterograde biliary drainage has the advantages of quick recovery and less complication compared to retrograde biliary drainage. Anterograde biliary drainage is the best choose of palliative biliary drainage given to the patients suffer from advanced hilar cholangiocarcinoma.