Background: Magnetic resonance cholangiopancreatography (MRCP) is a completely non-invasive technique that provides good projectional images without administration of contrast agents, without radiation, requires no anaethesia and less operator dependent.

AIM: The aim was to assess the role of magnetic resonance cholangiopanceatography (MRCP) in the diagnosis of malignant biliary obstruction .

Patients and Methods: This study included 20 patients with malignant biliary obstruction diagnosed clinically, by ultrasonography and/or MDCT to do MRCP for better evaluation.

Results: In our study, MRCP was accurate in the depiction the level of obstruction in the all 20 cases and showed 100% sensitivity, specificity and diagnostic accuracy in detecting the level of obstruction. MRCP showed significant preference in the ability to detect the cause of malignant obstruction, MRCP could diagnose the cause of malignant obstruction in (90%) of cases. Within our study, MRCP detected other related malignant features in 40% of cases.

Conclusion: Our data and in agreement with the previous studies has demonstrated that MRCP was accurate in the depiction the level of obstruction in the all 20 cases and showed 100% sensitivity, specificity and diagnostic accuracy in detecting the level of obstruction with no substantial complications.