Objective: To compare the safety and clinical feasibility between anterior liver hanging maneuver (ALH) and conventional approach for right hepatectomy. Methods: From January 2008 to June 2011, 40 patients scheduled to undergo right hepatectomy were randomly allocated to using ALH or conventional approach, with 20 cases in each group. The preoperative conditions, scope of hepatic resection, intraoperative events, postoperative complications, and alterations in biochemical parameters between the two groups were compared. Results: The preoperative data and scope of liver resection of the two groups were comparable. The incidences of intraopeative massive bleeding of two groups had no significant difference (P>0.05), but the intraoperative blood loss and blood transfusion volume in ALH group were significantly less than those in conventional approach group [(340.0±241.4) mL vs. (725.0±386.6) mL; (290.0±397.2) mL vs. (615.0±722.7) mL, both P<0.05], and the proportion of patients without any blood transfusion in ALH group was significantly higher than that in conventional approach group (16/20 vs. 10/20, P<0.05). The length of postoperative ICU stay and hospital stay, and the incidences of postoperative complications between the two groups had no significant differences (all P>0.05). The liver function parameters [including total bilirubin (TBIL), alanine transaminase (ALT), aspartate transaminase (AST), proalbmin (PA) and prothrombin time (PT)] had no statistical significances between the two groups before operation and on postoperative day (POD) 1 (all P>0.05). In ALH group, the C-reactive protein (CRP) level was significantly increased on POD 1, while the TBIL, ALT, AST and PT were significantly increased and PA was significantly decreased from POD 3 to 7 compared with conventional approach group (all P<0.05). No significant differences were noted in the renal function parameters [including blood urea nitrogen (BUN) and creatinine] between the two groups before and after operation (all P>0.05). Conclusion: Anterior liver hanging maneuver is associated with higher intraoperative safety, and better protection of postoperative liver function than conventional procedure for right hepatectomy.