Objective: To compare the clinical efficacy of anterior approach and conventional approach in right hemihepatectomy for hepatocellular carcinoma. Methods: Literature on studies comparing anterior approach and conventional approach for right hemihepatectomy in treatment of hepatocellular carcinoma was obtained through computerized and manual searches. The quality of the included studies was assessed, according to the Cochrane guidelines, and after data extraction, the Meta-analysis was performed by RevMan 5.3 software. Results: Nine studies were finally included, involving 1 344 patients, of whom 619 cases received anterior approach operation and 725 cases underwent conventional approach operation. The results of Meta-analysis showed that patients undergoing anterior approach operation were superior to those undergoing conventional approach operation in 1, 3-year overall survival (OR=1.85, 95% CI=1.25–2.71, P=0.002; OR=3.11, 95% CI=2.16–4.46, P<0.00001) and disease free survival (OR=2.27, 95% CI=1.60–3.22, P<0.00001; OR=3.13, 95% CI=2.11–4.64, P<0.00001) as well as perioperative mortality (OR=0.33, 95% CI=0.15–0.70, P=0.004); there was no statistical difference in operative time, intraoperative blood loss, incidence of postoperative complications and length of hospital stay between patients undergoing anterior approach operation and conventional approach operation (all P>0.05). Conclusion: Anterior approach right hemihepatectomy is safe and better in meeting the tumor-free principle than conventional approach, and it can also improve the overall survival rate, disease-free survival rate and reduce perioperative mortality.