Objective: To compare the accuracy of the scoring systems of Child-Pugh (CP), model for end-stage liver disease (MELD) and albumin-bilirubin scoring model (ALBI) in predicting posthepatectomy liver failure (PHLF) in liver cancer patients after R0 resection. Methods: The data of 275 liver cancer patients undergoing R0 resection and meeting the study criteria from September 2010 to November 2015 were collected. The abilities in predicting the occurrence of PHLF among the three scoring systems were compared by using Receiver operating characteristic (ROC) curves. Results: According to 50-50 criteria, 43 cases in the 275 patients were diagnosed with PHLF; the area under the ROC curve (AUROC) (95% CI) for ALBI, CP and MELD in diagnosis of PHLF was 0.930 (0.893–0.957), 0.795 (0.743–0.841) and 0.736 (0.680–0.787), respectively (ALBI vs. CP: P=0.0003; ALBI vs. MELD: P=0.0001; CP vs. MELD: P=0.2420). According to criteria of International Study Group of Liver Surgery (ISGLS), 48 cases in the 275 patients were diagnosed with PHLF; the AUROC (95% CI) for ALBI, CP and MELD in diagnosis of PHLF was 0.884 (0.840–0.920), 0.828 (0.778–0.871) and 0.762 (0.707–0.811), respectively (ALBI vs. CP: P=0.1542; ALBI vs. MELD: P=0.0064; CP vs. MELD: P=0.2010). The results of subgroup analysis stratified by liver resection scope were generally consistent with those of whole group analysis. Conclusion: Among the three scoring system, ALBI scoring is superior to CP and MELD scoring in predicting the occurrence of PHLF in liver cancer patients after R0 resection, and MELD scoring (due to greater value of weighting coefficient of the creatinine in the scoring system) might not be applicable for early-stage patients with mild symptoms.