Objective To investigate the effect of visual laryngoscopy in oronasal conversion of nasobiliary one-time success rate and incidence of adverse events.Methods 72 patients with endoscopic nasobiliary drainage (ENBD) were divided into experimental group and control group, with 36 patients per group. Control group performed conventional guidewire oronasal conversion, and the experimental group performed it with the assistance of visual laryngoscopy.Results The one-time success rate was 100.0% (36/36) in experimental group, 83.3% (30/36) in control group; In the experimental group, 1 case had cough, no catheter slippage or catheter buckling occurred, the incidence of adverse events was 2.8% (1/36), in the control group, there were 4 cases of cough, 3 cases of catheter slippage, 2 cases of catheter bending and discounting, and the incidence of adverse events was 25.0% (9/36).Conclusion Visual laryngoscopy in oronasal conversion of nasobiliary can improve the one-time success rate, effectively reduce the discount and slip off of nasobiliary, improve work efficiency and patient satisfaction, and reduce the incidence of adverse events.