Objective: To investigate the application value of 3D visualization technique in the preoperative planning of patients with central liver tumor. Methods: The clinical data of 28 patients with central liver tumor that underwent preoperative evaluation by 3D visualization technique during January 2016 to November 2017 were analyzed retrospectively. Before operation, the two-dimensional CT images of the patients were obtained and imported into 3D visualization software. In the liver, hepatic artery system, portal vein system, hepatic venous system and tumor, image segmentations and 3D reconstructions were performed respectively. Then the subsection of the liver, the classification of the central liver tumor and calculation of the individual liver volume were performed. Based on the results of 3D reconstruction, the surgical planning was made, and the rational surgical approaches and procedures were selected. Results: The 3D visualization model was successfully established in all of the 28 patients. The anatomies of the intrahepatic vascular system and the exact site, size and adjacent relations of the tumor were displayed, and the individual liver segmentation and classification of the central liver tumor were made through 3D technique. The median total liver volume was 1 532 (1 025–1 864) mL, volume of liver tumor was 466 (45–558) mL and volume of virtual resection liver was 595(108~806) mL. Radical resection of tumor was performed in all of the 28 patients. The coincidence rate between the actual surgical approaches and preoperative surgical planning was 100%. The median intraoperative blood loss and amount of blood transfusion were 700 (100–2 000) mL and 600 (0–1400) mL, the rate of blood transfusion was 71.42% (20/28) and the incidence of complications was 28.57% (8/28). No postoperative liver failure occurred and the in-hospital mortality rate was 0. Conclusion: 3D visualization technique can calculate the volume of residual liver, improve the accuracy and safety of the preoperative planning of hepatectomy for central liver tumor, and is helpful for the precise operation during surgery.