Abstract: Objective To investigate the efficacy of surgical treatment of hepatocellular carcinoma（HCC） with portal vein tumor thrombi（PVTT）.Methods From January 1998 to December 2008，the data of 34 patients of hepatocellular carcinoma with PVTT who had undergone operation were analyzed retrospectively. Results There were 2 cases of death within one month after operation，32 patients gained good recovery. Twentynine cases were followed up（90.6％），the median survival time was 16.2 months，the overall 1-，2-，3-，4-，5-year survival rates were 51.7％，37.9％，24.1％，10.3％ and 3.4％，respectively. There were 23 patients who recevied portal vein（PV） and hepatic artery catheterizing chemotherapy；the overall 1-，2-，3-，4-，5-year survival rates were 57.1％，42.9％，28.6％，14.3％ and 4.7％，respectively.The median survival time was 19.6 months.There were 9 patients with only surgical operation； the overall 1-，2-，3-，4-，5-year survival rates were 45.0％，22.2％，11.1％，0 and 0， respectively. The median survival time was 13.5 months. There were statistical differences between two groups（P＜0.05）. Conclusion Resection of HCC and removal of tumor thrombus in the portal vein is an effective method for hepatocellular carcinoma with tumor thrombus in the portal vein. Postoperative catheterizing chemotherapy may increase survival rates.