Background and aim: Indications of preoperative biliary drainage (PBD) for malignant obstructive jaundice are still controversial. The present study aims to assess the impact of preoperative biliary drainage on postoperative outcome, to define the indications for biliary drainage in patients undergoing radical resections and to define the optimal timing of surgical resections following PBD with consideration of postoperative morbidity and survival. Methods: Between January 2017 and August 2018 consecutive one-hundred and fifty-eight patients with malignant obstructive jaundice who underwent radical resections at a single institution were enrolled. Their data were reviewed retrospectively. Results: Seventy-seven patients underwent PBD. The mean duration between drainage and surgery was 23.2days. Length of hospital stay was longer in PBD group (P = 0.102), and PBD reduced hemorrhagic complications (P=0.045) but not overall postoperative morbidity (P = 0.380). Conclusion: PBD could reduce hemorrhagic complications by selecting appropriative cases.