Aim — to evaluate the role of confocal laser endomicroscopy (CLE) in diagnosis of extrahepatic biliary strictures. Material and methods. There were 102 patients with common bile duct strictures. Patients were divided into 2 groups: the main group consisted of 28 patients (men 57.1%, women 42.9%; mean age — 67±7.8 years); control group — 74 patients. In the main group data of endoscopic retrograde cholangiopancreatography (ERCP), cholangioscopy (CS), CLE and biopsy were compared with results of postoperative biopsy or autopsy. In the control group patients underwent ERCP with biopsy of stricture zone under x-ray control. Results. Benign extrahepatic biliary strictures were revealed in 15.7 and 34.3% in the main and control groups, respectively, malignant strictures — in 11.8 and 38.2%, respectively. Sensitivity, specificity and accuracy of ERCP and biopsy in diagnosis of malignant strictures of common bile duct were 17.9, 71.4 and 43.2%, respectively. CS and CLE in addition to routine endoscopic examination were useful to identify characteristic confocal signs of benign (inflammation of common bile duct wall) and malignant stricture (thickening of collagen network and vascular enlargement). Sensitivity, specificity and accuracy of the whole complex of ERCP, CS, CLE and biopsy were 91.7, 93.7 and 92.8%, respectively. Conclusion. CS and CLE are indicated for unclear obstructive stenosis of common bile duct for visual assessment of stricture and biopsy. CLE is advisable if visual data are also unclear. Diagnostic sensitivity, specificity and overall accuracy of X-ray-assisted biopsy for malignant strictures are low while biopsy during choledochoscopy and CLE makes it possible to increase these values up to 91.7, 93.7 and 92.8%, respectively.