Although the prevalence of hilar cholangiocarcinoma (HC) is relatively low, it is associated with dismal prognosis, and surgical resection remains the only curative treatment for this condition. Over more than half a century, considerable achievements have been made in surgical treatment of HC, meanwhile, the accompanied controversies still exist. The authors, in this paper, discuss the issues concerning the preoperative staging and management, and surgical resection scope, combined vascular resection with reconstruction, number and scope of lymph node dissection, laparoscopic procedure and liver transplantation for HC, so as to provide helpful guidance for surgical management of HC.