BACKGROUND: Choledochoduodenostomy is performed for a variety of lower common bile duct lesions. AIMS: To analyse the influence of risk factors on the post-operative morbidity following choledochoduodenostomy. METHODS: Relation of risk factors including age more than 60 years, medical Illness, hemoglobin less than 10 g/dL, albumin less than 3 g/dL, bilirubin more than 10m/dL, presence of cholangitis at admission (treated pre-operatively), use of pre-operative endoscopic sphincterotomy and common bile duct diameter at surgery were related to the occurrence of post-operative morbidity was studied using univariate analysis. RESULTS: Fifty patients underwent choledochoduodenostomy. One patient (2%) died; major post-operative morbidity occurred in 12 patients (24%). Presence of cholangitis at admission was the only factor related (p = 0.00012) to the occurrence of post-operative morbidity. No long-term complications were encountered in 35 patients (70%) mean with followup period of 28 (range 8-60) months. CONCLUSIONS: Choledochoduodenostomy is a safe permanent drainage procedure for benign lower biliary obstruction.