Background: Preoperative biliary drainage by means of endoscopic biliary stenting is thought to improve outcomes by re-establishing enterohepatic circulation prior to pancreaticoduodenectomy. However, recent evidence suggests that it may be associated with increased postoperative infective complications. Objective: The objective of this study was to evaluate the relationship between preoperative biliary stenting and postoperative infectious complications. We also investigated the correlation of intraoperative bile bacteriology to postoperative bacterial culture from wound infection or deeper collection. Material and methods: All patients who underwent Pancreaticoduodenectomy at Shaukat Khanum Memorial Cancer Hospital and Research Centre from January 2014 to December 2018 were included in the study. Results: Out of 161 patients, 119 (74%) patients underwent pre-operative endoscopic biliary stenting before pancreatoduodenectomy. The overall morbidity rate was 65% and 30-day mortality was 3%. Intra-operative bile cultures were positive in 67% patients of which 37% patients had polymicrobial growth. The most common organism isolated was e-coli (35%). Bile and wound cultures had similar microbial growth in 21% patients. On comparison, bile cultures were positive in 78% of stented patients versus 33.33% in the group with no stents (p= 0.000). We found significantly higher rates of both superficial surgical site and deep incisional infections in the stented group (p=0.012, p=0.045). There was no statistical difference in the overall complications and mortality rates amongst the two groups. Conclusion: Preoperative ERCP and stent placement is a risk factor for infective complications following pancreaticoduodenectomy.