Purpose: To prove efficacy of endoluminal radiofrequency ablation before stenting of malignant biliary stenoses. Methods and Materials: 54 patients with histologically proven malignant biliary stenoses have been enrolled in a prospective randomised study from 2010. 73 non-covered self-expandable metal stents were inserted. In group A (n=22) the endoluminal ablation with a bipolar radiofrequency catheter (EndoHPB;EMcision Ltd.,London,UK) was performed 0-48hours prior to the stent insertion, in group B (n=32) the stent was implanted without a prior ablation. The primary endpoints of the study were to determine the rate of complications, duration of stent patency and survival of patients (Kaplan-Meyer analysis). Results: No major complications related to the stent insertion and endoluminal ablation were recorded. 30 day mortality was 3.7%. The average primary stent patency was 5.6 and 5.2 months in group A and B, respectively, 3-months and 6-months stent failure was 9.1% and 13.6% in group A and 15% and 25% in group B. The median survival from the insertion of the stent was 5.9 (2.9-6.7) and 5.4 (3.7-8.6) months, the median survival from the initial drainage was 9.6 (5.6-12.2) and 8.5 (5.8-12.7) months in group A and B, respectively. The difference was not statistically significant. Conclusion: In the prospective randomised clinical study the effect of an endoluminal ablation on patients survival was not proven. However, in the group of patients undergoing ablation there is a tendency of a lower rate of early stent failure. In addition, the intervention was not associated with higher rates of complications.