Intrahepatic cholangiocarcinoma (ICC) arising from the epithelial cells of the second order bile ducts and their branches, is one of the liver cancers with high degree of malignancy and poor prognosis. Lymph node metastasis is the most important factor affecting the prognosis of ICC patients. Recently, many studies indicated that hepatitis B virus (HBV) is an independent risk factor for ICC, and the clinical manifestations in patients with HBV-associated ICC are similar to those with hepatocellular carcinoma. Further, the latest studies demonstrated that the prognosis in HBV-positive ICC patients is better than that in HBV-negative patients, and HBV-positive ICC patients have a relatively low rate of lymph node metastasis. Thus, further insight into the actions of HBV on the pathogenesis and outcomes of ICC is of great clinical significance.