We performed comparative investigations of the Ag1-xPb18MTe20 (M = Bi, Sb) (x = 0, 0.14, 0.3) system to better understand the roles of Sb and Bi on the thermoelectric properties. In both systems, the electrical conductivity nearly keeps the same values, while the Seebeck coefficient decreases dramatically in going from Sb to Bi. Compared to the lattice thermal conductivity of PbTe, that of AgPb18BiTe20 is substantially reduced. The lattice thermal conductivity of the Bi analog, however, is higher than that of AgPb18SbTe20 and this is attributed largely to the decrease in the degree of mass fluctuation between the nanostructures and the matrix (for the Bi analog). As a result the dimensionless figure of merit ZT of Ag1-xPb18MTe20 (M = Bi) is found to be smaller than that of Ag1-xPb18MTe20 (M = Sb).