Abstract: Objective To analyze the clinical efficacy and application of biliary double stents implant combined with biliary extra-drainage in the treatment of malignant high biliary obstruction(MHBO). Methods We retrospectively analyzed 96 MHBO patients, including 77 cases of biliary double stents combined with biliary extra-drainage, 11 cases of biliary single stent implant with contralateral drainage, and 8 cases of simple biliary extra-drainage. The short- and long-term curative effects were observed after operation. Results As for 77 cases of biliary double stents combined with biliary extra-drainage, its success rate was 80.21%. As for 96 MHBO patients, total bilirubin, TBIL, direct bilirubin, DBIL, alanine transaminase, ALT, aspartate transaminase and AST before operation were significantly different from those on the 7th, 14th day after operation（P<0.05）. Total bilirubin droop rate of patients with biliary double stents implant (92.56%) was obviously higher on postoperative 21st day than those of patients with biliary single stent implant with contralateral drainage and with simple biliary extra-drainage(61.53%) (P<0.05). As for 77 patients with biliary double stents implant, the survival rates were 98.70%, 88.31%, 76.62%, 88.31%, 18.18%, 2.6%, 1.3% after 3, 6, 9, 12, 15, 18, 21 months, respectively. Conclusion Biliary double stents implant combined with biliary extradrainage is a safe and effective method to treat MHBO; it could not only quickly remove jaundice and recover liver function for further treatment of tumor, but also improve patients' quality of life and extend the lifetime.