Abstract: Hilar cholangiocarcinoma (HCCa) is a biliary malignancy that seriously affects the survival of patients. Radical resection is the only cure method for patients to achieve long-term survival. However, due to the low rate of radical resection, its prognosis is poor. In this article, surgical treatment strategies of HCCa in the precision surgery era, 3D image evaluation in the curative resection, surgical procedure decision and the preservation of liver parenchyma in the hepatic resection are discussed combined with the research progress at home and abroad.