Objective To investigate the value of enhanced CT combined with MRI in the differential diagnosis of benign and malignancy biliary strictures. Methods A total of 68 cases of patients with biliary stricture from March 2015 to June 2016 to our hospital were selected as the research object, all patients underwent MRI and enhanced CT examination, with surgical pathology results as the reference standard, and observe these two methodss to check the results of the inspection and compared the diagnostic rate of two kinds of methods, and to create different test subjects working characteristic curve (ROC curve), calculate the area under the curve (AUC). Results The diagnostic accuracy of MRI was 89.71%, the misdiagnosis rate was 10.81% and the sensitivity was 90.32%, and the specificity was 89.19%. The diagnostic accuracy of enhanced CT was 95.59%, the misdiagnosis rate was 2.86%, the sensitivity was 93.75%, and the specificity was 94.44%. The accuracy, sensitivity, speciality degree, AUC value (0.876) of MRI combined with enhanced CT were higher than that of single check (0.751, 0.751), except the accuracy differences were significant (P<0.05), the misdiagnosis rate is lower than that of single test, there was no significant difference (P>0.05). Conclusion Enhanced CT and MRI are effective methods for the diagnosis of bile duct stenosis, and the combination of the two methods has good diagnostic efficacy and has certain clinical reference value.