Objective To explore the therapeutic effect and influencing factors of percutaneous transhepatic biliary stent placement for malignant obstructive jaundice. Methods 426 patients with malignant obstructive jaundice admitted to our hospital from May 2015 to May 2017 were enrolled. The clinical and followup data of all patients were analyzed by retrospective analysis. All patients were treated with percutaneous transhepatic biliary stent placement after complete examination and preparation. The general clinical data such as gender and age and diseaserelated conditions of all patients were recorded. Changes in clinical indicators before and after treatment in all patients and the differences in the above data among patients with different clinical treatment effects were compared. The factors affecting the efficacy of percutaneous transhepatic biliary stent placement in the treatment of patients with malignant obstructive jaundice were analyzed. Results According to the clinical data, 426 cases of malignant obstructive jaundice were treated with percutaneous transhepatic biliary stent placement. The clinical effect was significant in 324 cases, poor in 102 cases, and the clinical effective rate was 76.06%. The direct, indirect and total bilirubin levels of all patients with malignant obstructive jaundice after treatment with percutaneous transhepatic biliary stent placement were significantly lower than those before treatment (P＜0.05). Analysis by unconditional single factor logistic regression model, the clinical effective rates of patients with malignant obstructive jaundice with preoperative KPS score less than 50, postoperative complications, preoperative liver function grade was Child-Pugh C grade and preoperative total bilirubin level over 300umol were significantly lower (P＜0.05). Further analysis by unconditional multivariate logistic regression showed that, the preoperative KPS score less than 50, postoperative complications, preoperative liver function grade was Child-Pugh C grade, and preoperative total bilirubin level over 300umol/ L were independent risk factors for poor clinical treatment after percutaneous transhepatic biliary stent placement in patients with malignant obstructive jaundice (P＜0.05). Conclusion Percutaneous transhepatic biliary stenting for the treatment of malignant obstructive jaundice can significantly reduce the bilirubin level and has a good clinical effect. The preoperative KPS score less than 50 points, postoperative complications, preoperative liver function grade, and preoperative total bilirubin level over 300umol/ L are independent risk factors for poor clinical outcomes.