Objective <p>To evaluate the clinical efficacy of percutaneous hepatic puncture biliary drainage combined with metal stent implantation in the treatment of malignant obstructive jaundice, focusing on improvements in liver function, bile duct patency time, and reduction of postoperative complications.</p> Methods <p>181 patients with malignant obstructive jaundice were retrospectively selected from a hospital in Ganzhou City, Jiangxi Province, from April 2021 to May 2024, of which 132 underwent routine percutaneous liver puncture biliary drainage and 49 underwent percutaneous liver puncture biliary drainage combined with metal stent implantation as the observation group.</p> Results <p>The clinical efficacy of the observation group was higher (<i>P</i> &lt; 0.05), and the bile duct patency time was longer (<i>P</i> &lt; 0.05). The AST, ALT, DBIL and TBIL levels were decreased 1 week and 1 month after surgery, and the decrease was more significant in the observation group (<i>P</i> &lt; 0.05). In addition, the incidence of postoperative complications (bile duct infection and electrolyte disturbance) in the observation group was lower (<i>P</i> &lt; 0.05).</p> Conclusion <p>Percutaneous hepatic puncture biliary drainage combined with metal stent implantation has significant clinical efficacy, which can effectively improve the clinical symptoms of patients, prolong the biliary patency time, reduce the level of bilirubin, promote the improvement of liver function, and lower the incidence of postoperative complications.</p> Clinical trial number <p>not applicable.</p>