Objective: To compare the clinical efficacy of anterior approach and conventional right liver resection for treatment of large right lobe liver tumors. Methods: The clinical data of 30 patients (observation group) with hepatocellular carcinoma undergoing anterior approach right hepatectomy from January 2007 to December 2009 were retrospectively analyzed, and another 30 similar patients undergoing conventional hepatectomy during the same period served as control group. The surgical efficacies between the two groups of patients were compared. Results: The average tumor size in observation group was larger than that of control group (P<0.05). There were no significant differences in operative time and number of tumor rupture cases between the two groups (both P>0.05), while the average amount of intraoperative blood loss, number of patients who had massive hemorrhage or required blood transfusion during operation, and average length of hospital stay in observation group were significantly reduced compared with control group (all P<0.05). The rates of postoperative complications, mortality, and recurrence between the two groups showed no obvious differences (all P>0.05), but the 1- and 3-year survival rate in patients of observation group were significantly higher than those of control group (both P<0.05). Conclusion: The anterior approach right hepatectomy can be used as the option of choice for large right lobe liver tumors, as it can reduce intraoperative bleeding and the rate of postoperative complications and death, and can increase survival rate of the patients.