Malignant biliary obstruction can be caused by primary biliary malignancy , periampullary malignancy , gall bladder malignancy, hepatic malignancy , metastasis and metastatic portal nodes compressing or invading the hila, adjacent malignancy invading the biliary duct . Most of the biliary obstruction caused by the malignancy presents in the advanced inoperable stage with painless progressive jaundice .The delay may be because of delay by the patient ,misdiagnosis as benign pathologies like hepatitis , gall stones , benign strictures and because of many alternative medicine treatment particularly in india By the time the patient presents with jaundice most of the malignancy will be in advanced stage. Various methods to deal with the malignantzobstruction can be surgical bypass , endoscopic biliary stenting , percutanous biliary stenting.