Palliative surgery is still a major form of treatment in malignant biliary obstruction. Its results, however, have to be compared with those of non-surgical methods. The quality of life is often excellent after palliation, even when the slightly higher mortality and morbidity rates are taken into account. Furthermore, the case of curative resection is often decided peroperatively, and this chance should be given to every patient for whom there is no definite contraindication to resection during the preoperative assessment.