Objective: To study the effect of endoscopic nasobiliary drainage and percutaneous transhepatic biliary drainage in the treatment of acute obstructive suppurative cholangitis. Methods: 335 cases of patients with acute obstructive suppurative cholangitis in our hospital were divided into group A, B,C according to different treatment methods, group A of 125 cases of patients used traditional common bile duct and T tube drainage, group B of 100 cases of patients used endoscopic nasobiliary drainage, and group C of 110 cases of patients used percutaneous transhepatic biliary drainage. The curative effect, purulent bile drainage, serum bilirubin level of 1 week after treatment, hospitalization time and complication rate of the three groups were compared. Results: The total effective rate of group B and group C were 91.0%(91/100) and 90.9%(100/110), significantly higher than 71.2%(89/125) of group A, the difference was statistically significant(P<0.05), there was no significant difference in the effective rate between group B and group C(P>0.05). The purulent bile drainage volume, postoperative serum bilirubin level of 1 week after treamtent, and hospitalization time of group B and group C were better than those of group A,with significant difference(P<0.05), there was no significant difference between group B and group C(P>0.05); The complication rate of group B and group C were 11.0%(11/100) and 8.2%(9/110), significantly lower than 28.0%(35/125) of group A, with significant difference(P<0.05). Conclusion: The effect of endoscopic nasobiliary drainage and percutaneous transhepatic biliary drainage is obviously superior than the traditional open operation in the treatment of acute obstructive suppurative cholangitis, with less postoperative complications, it is worthy of popularization and application. [ABSTRACT FROM AUTHOR]