Background: Percutaneous biliary drainage (PTBD) is a palliative treatment for malignant biliary obstruction. The present study adopted different methods of fixing the drainage tube, aiming to evaluate the efficacy and complications for patients. Materials and Methods: Total 68 patients with malignant biliary obstruction, enrolled from 2015 May to 2018 March, were randomly divided into two groups to perform PTBD. 34 patients in group A were fixed the drainage tube by using the traditional way and 34 patients in group B by using an ameliorated approach. The clinical success rate, level of direct/indirect bilirubin, complications and quality of life of patients were recorded. Results: PTBD was successfully performed on all 68 patients. The direct and indirect bilirubin levels of all patients were significantly decreased at 1-week and 1-month post-surgery (P<0.001). Compared with group A, the level of direct bilirubin in group B decreased more significantly at 1-month after the operation (P<0.05). The quality of life of patients was improved in the two groups at 1-month after the operation (P<0.001). In addition, the rate of early postoperative complications was 38.24% in group B, which was not significantly different from the rate in group A (41.18%) (P>0.05). However, the complication rate of late postoperative in group B (6/34) was significantly less than complication rate in group A (16/34) (P<0.05). Conclusion: PTBD is an effective method of treating malignant biliary stricture. The ameliorated fixing method for the drainage tube in PTBD effectively decreases the incidence of late complications, further improving patient quality of life.