Objective: To systematically evaluate the short-term clinical efficacy of precise hepatectomy in treatment of primary liver cancer. Methods: The randomized controlled trials (RCTs) and clinical controlled trials (CCTs) comparing precise hepatectomy and conventional hepatectomy for primary liver cancer were collected by searching several national and international databases. After screening for inclusion, quality assessment and data extraction, Meta-analysis was performed by the RevMan 5.3 software. Results: Six RCTs and 9 CCTs were finally included, with total of 1 367 patients, of whom 685 cases underwent precise hepatectomy (precise group) and 682 cases were subjected to conventional hepatectomy (control group). Results of the Meta-analysis showed that in precise group compared with control group, the intraoperative blood loss, perioperative blood transfusion and length of hospital stay were reduced, but the operative time was prolonged (MD=–175.45, 95% CI=–234.37––116.53; MD=–311.04, 95% CI=–444.53––177.55; MD=–3.11, 95% CI=–4.36––1.87; MD=31.72, 95% CI=12.00–51.44, all P<0.05), the complete resection rate was improved (OR=0.18, 95% CI=0.07–0.45, P=0.0003), recover of liver function was accelerated (ALT: MD=–81.75, 95% CI=–109.50––54.00; AST: MD=–67.27, 95% CI=–94.36––40.18; TBIL: MD=–4.54, 95% CI=–7.33––1.75; ALB: MD=3.75, 95% CI=0.54–6.97, all P<0.05), and the incidence of complications was decreased (OR=0.24, 95% CI=0.17–0.35, P<0.05). The 1-year recurrence rate was decreased and 1-year survival rate was increased (OR=0.56, 95% CI=0.37–0.85; OR=1.61, 95% CI=1.01–2.57, both P<0.05). Conclusion: Precise hepatectomy results in less trauma, quicker recovery and better short-term outcomes than the conventional method in treatment of primary liver cancer.