OBJECTIVE： To observe therapeutic efficacy and safety of different gemcitabine dosage regimens combined with oxaliplatin in the treatment of recurrent metastatic cholangiocarcinoma. METHODS： A total of 100 patients with recurrent metastatic cholangiocarcinoma were randomly divided into group A（50 cases） and B（50 cases）. Group A was given Gemcitabine hydrochloride for injection 1 000 mg/m2，d1、8， for fixed drip time 30 min+Oxaliplatin for injection 130 mg/m2，d1， intravenously. Group B was given gemcitabine 1 000 mg/m2，d1、8，with fixed infusion speed of 10 mg/（m2·min）+ Oxaliplatin for injection （same usage and dosage as group A）. A treatment course lasted for 3 weeks， and both groups received 2 courses. Clinical efficacies and toxic reaction of 2 groups were observed， and total survival time， progression-free survival time of 2 groups were followed up for 3 years. RESULTS： Both groups completed at least 2 courses of treatment. The objective remission rate and disease control rate of group B were significantly higher than those of group A； total survival time and progression-free survival time of group B were significantly longer than those of group A. The incidence of Ⅲ-Ⅳ degree thrombocytopenia and leucopenia in group B were significantly higher than group A， with statistical significance（P＜0.05）. CONCLUSIONS： Gemcitabine dosage regimen of fixed infusion speed combined with Oxaliplation is better than Gemcitabine dosage regimen of fixed drip time for recurrent metastatic cholangiocarcinoma patients in controlling the disease progression， prolonging the survival time and improving the long-term prognosis， but may increase the risk of blood related ADR.