Abstract: Objective To investigate the clinical effect of insertion of bile duct stent through endoscopic retrograde cholangiopancreatography (ERCP) in the treatment of advanced stage malignant obstructive jaundice (MOJ). Methods A total of 74 patients with advanced malignant obstructive jaundice in our hospital from February, 2013 to February, 2016 were selected, all patients were treated with insertion of bile duct stent through ERCP, and the basic situation, therapeutic effects, liver function, immune function, postoperative complications and survival time were observed. Results Among the 74 patients, 72 cases were successfully treated with biliary stent, the successful rate was 97.3%. The average hospitalization time was (14.74±4.26) days, and the average hospitalization cost was (25 446.59±3 264.55) yuan. One week after the operation, the total effective rate was 94.4%, the levels of serum direct bilirubin (DBIL), total bilirubin (TBIL), alanine glycosylase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP) and glutamyltranspeptidase (GGT) decreased significantly (P<0.05). One week after the operation, the levels of CD4⁺ and CD4⁺/CD8⁺ increased significantly (P<0.05) and the level of CD8⁺ decreased significantly compared with preoperative (P<0.05). The incidence of postoperative complications was 5.56% and the average survival time was (14.25±5.38) months. Conclusion The insertion of bile duct stent through ERCP in the treatment of advanced malignant obstructive jaundice has a significant effect, which can significantly improve the liver function, immune function and prognosis, and can be used as a palliative treatment for advanced malignant obstructive jaundice.