We present a clinical case of morphological diagnosis and multistage endoscopic treatment of obstructive jaundice in a patient with a combination of Crohn’s disease, primary sclerosing cholangitis, and colorectal adenocarcinoma T4N2M0. The patient was admitted to the clinic for obstructive jaundice. Upon further examination, the formation of a common bile duct was diagnosed. Differential diagnosis was made between primary cholangiocarcinoma and secondary metastatic lesion of the hepatic hilum with invasion of the common bile duct. The data of visual research methods (magnetic resonance imaging, endoscopic ultrasonography, computed tomography) didn’t make it possible to make a definitive diagnosis of damage to the bile ducts and liver. The histological examination of the material obtained by fine-needle aspiration puncture under the control of endoscopic ultrasonography and by forceps biopsy during endoscopic retrograde cholangiopancreatography was of decisive importance. The treatment of obstructive jaundice was complicated by the presence of a combined mechanism of damage to the bile ducts (the presence of neoplasm of the common bile duct and primary sclerosing cholangitis).