Objective:To investigate the diagnostic value of SpyGlass endoscopy system (short for SpyGlass) for indeterminate bile duct stricture.Methods:Data of patients who underwent SpyGlass examination for indeterminate bile duct stricture at Hangzhou First People′s Hospital from September 2012 to August 2017 were reviewed. The diagnostic value of SpyGlass for indeterminate bile duct stricture was analyzed.Results:A total of 88 patients with indeterminate biliary stricture were diagnosed with SpyGlass. The procedure success rate was 97.7% (86/88). The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of SpyGlass for indeterminate bile duct stricture were 98.1%(52/53), 96.9% (31/32), 97.6% (83/85), 98.1% (52/53)and 96.9% (31/32), respectively. Three patients (3.5%, 3/86) had postoperative complications and were cured by conservative treatment.Conclusion:SpyGlass is safe and effective for indeterminate biliary stricture with high sensitivity and accuracy and low incidence of complications.