A consensus is growing among units that have experience in both endoscopic and percutaneous stenting techniques that the endoscopic approach to malignant biliary strictures is more comfortable for the patient and has fewer complications. This article describes endoscopic biliary drainage in malignant stenoses of the bile ducts and delineates the respective indications for percutaneous and endoscopic techniques. New materials have become available for endoscopic and percutaneous biliary drainage, particularly metallic stents which may provide better palliation.