Abstract: Hepatocellular carcinoma (HCC) combined with inferior vena cava (IVC) tumor thrombosis is regarded un resectable. Most of the patients received non surgical treatment or gave up treatment, and the prognosis of these patients is poor. As the development of surgical treatment, the success rate of surgical treatment for HCC combined with IVC tumor thrombosis is increasing yearly. In May of 2012, one patient with HCC combined with IVC tumor thrombosis received hepatic Ⅴ, Ⅶ and Ⅷ segmentectomy+tumor thrombosis removal from the IVC at the Second Affiliated Hospital of Harbin Medical University. Preoperative computed tomography showed space occupying lesions in the segments Ⅴ, Ⅶ and Ⅷ, and the IVC was filled with tumor thrombi. The volume of the left liver was 489 cm 3, which was under the limit for survival. In order to preserve the remnant liver, right hepatectomy with reservation of hepatic segment Ⅵ, and the tumor thrombi in the IVC were removed with total hepatic vascular exclusion. The patient was recovered with no tumor recurrence or metastasis at postoperative month 18.