Objective: To assess the advantages of using fast track surgery (FTS) during perioperative period in patients undergoing hepatectomy for liver cancer. Methods: Two hundred and ninety-seven patients with hepatocellular carcinoma were randomly designated to either FTS group (135 cases) or control group (162 cases) adopting the traditional perioperative treatment measures. The patients in FTS group received the perioperative management pathway guided by the FTS concept, while those in control group underwent conventional perioperative treatment. Comparisons were made between the two groups with respect to the intraoperative conditions, time to postoperative recovery, length of hospital stay, cost of hospital admission, and postoperative adverse events and complications. Results: In FTS group, the operative time was shorter, intestinal function recovery was earlier, and both hospital stay and cost were reduced compared with control group, and all the differences reached statistical significance (all P<0.05). However, no difference was noted in the postoperative adverse events and complications between the two groups (all P>0.05). Conclusion: Using FTS concept in the perioperative management of patients undergoing hepatectomy for liver cancer is safe and effective, and it can accelerate the postoperative recovery of these patients.