A two-step procedure for percutaneous transhepatic drainage (PTD) of the biliary tract was attempted on 101 patients with obstructive jaundice, 29 with benign and 71 with malignant lesions, and was successful in 100. With this procedure, marked clinical improvement, with reduction in levels of serum bilirubin, SGOT, SGPT and alkaline phosphatase, was achieved after 1–2 weeks as a preoperative step or for continuous drainage in inoperable cases. In one patient 8 days after PTD, however, a complicating large intrahepatic hematoma proved fatal. Emergency operation was necessary in three of the four patients who developed bile peritonitis due to dislocation of the catheter and in one with intra-abdominal bleeding. Our results suggest that this procedure is very useful in the diagnosis and management of certain obstructive diseases of the biliary tract.