Objective: To investigate the safety and feasibility of hemihepatectomy using anterior approach with liver hanging maneuver in patients with liver cirrhosis. Methods: From January 2008 to June 2011, 45 patients with liver cirrhosis scheduled for hemihepatectomy were selected and randomly designated either to using anterior approach with liver hanging maneuver (anterior approach group, 22 cases) or conventional approach (conventional group, 23 cases). Comparisons were conducted between the two groups in respect to the operative time, intraoperative blood loss, number of blood transfusion required, length of hospital stay and complications as well as the perioperative liver function parameters. Results: Operations were successfully performed in all patients of the two groups. In anterior approach group, 17 cases underwent right hepatectomy, 5 cases underwent left hepatectomy and the retrohepatic tunnel in all of them was created successfully. In conventional group, 19 cases underwent right hepatectomy and 4 cases underwent left hepatectomy. Compared with conventional group, anterior approach group had reduced intraoperative blood loss and number of blood transfusion required, shortened operative time, fewer postoperative complications, faster recovery of postoperative alanine aminotranferease (ALT) and aspartate aminotransferase (AST) levels (all P<0.05). No significant differences were seen in the length of hospital stay and change of postoperative total bilirubin (TBIL) level between the two groups (all P>0.05). Conclusion: Hemihepatectomy using anterior approach with liver hanging maneuver in patients with liver cirrhosis is safe and feasible, because it can reduce the intraoperative blood loss and operative time and accelerate liver function recovery.