Objective To investigate the role of ERCP in geriatric population (≥70 yr) with biliary obstruction.Methods 218 geriatric patients (≥70 yr) and 189 non-geriatric ones ( ＜70 yr) admitted during 2001.1～2007.12 who had undergone biliary drainage by ERCP were retrospectively studied.Results The mean ages in geriatric and non-geriatric group were 79±9 and 56±7 yr,respectively.The success rates of biliary drainage were 96.8% (211/218) and 97.4% (184/189) in geriatric and non-geriatric group,respectively.The procedure time of ERCP was (55±30)rain and (58±34)min in geriatric and non-geriatric group,respectively.The complication rates were 16.1% (35/218) and 13.8% (26/189),respectively.The mortality rates were 1.83% ( 4/218 ) and 1.06% ( 2/189 ),respectively.There were no statistically significant differences between the two groups.However,the re-intervention rates were 16.1% (35/218) in geriatric group,which was significantly higher than that of 5.8% (11/189) in non-geriatric group.Conclusions ERCP was a less invasive,safe and effective treatment option for geriatric patients with bile duct obstruction.