Objective: To investigate the clinical application of digital three-dimensional reconstruction technique in precise hepatectomy for liver cancer. Methods: Twenty one patients with primary liver cancer (tumor diameter >5 cm) treated from October 2015 to October 2017 were selected. All patients underwent plain and contrast enhanced CT scan of the liver before operation. Three-dimensional reconstruction of the liver was performed by Myrian reconstruction software. The intrahepatic vessels, location and size of the tumor and their relationship in the patients were analyzed, and the total liver volume (TLV), standard liver volume (SLV), functional liver volume (FLV), tumor volume (TuV), virtual resection liver volume (vRLV), virtual resection specimen volume (vRSV) and residual liver volume (RLV) were calculated. The intraoperative actual specimen weight (aRSW) and actual specimen volume (aRSV) were determined. After that, the accuracy of vRSV was examined and analyzed and the correlations among vRSV, aRSV and aRSW were analyzed. Results: In the 21 patients, the TLV was (1 827.9±314.8) cm3, TuV was (593.4±283.2) cm3, vRLV was (511.2±180.0) cm3 and vRSV was (1 104.6±292.3) cm3; the aRSW obtained after operation was (1 212.9±278.46) g. There was no significant difference between vRSV and aRSV (P=0.76). Pearson test showed that there were significantly positive correlation between aRSV and vRSV, aRSW and vRSV and aRSW and aRSV (r=0.9 964, 0.9 201, 0.9 345, all P<0.0 001). The preoperative virtual surgery simulations were consistent with the actual surgical protocols. None of the 21 patients had hepatic encephalopathy or liver failure after operation, and no death occurred during the perioperative period. Conclusion: The three-dimensional reconstruction of liver combined with liver function assessment before operation has great value for surgical procedure selection of precise liver cancer resection, for its precise tumor positioning, automatic segmentation and quantitative analysis, especially liver volume calculation and virtual liver resection.