Background and Aims It is still a short period since the laparoscopic ultrasound (LUS) liver resection was employed in clinical practice, and the reports on the efficacy of its application in primary liver cancer (PLC) is also limited. Therefore, this study was conducted to investigate the short-term prognosis of LUS left hemihepatectomy for PLC and its influence on liver function.Methods The clinical data of 64 patients with PLC treated from January 2017 to January 2020 were retrospectively analyzed. Of the patients, 30 cases underwent left hemihepatectomy (LUS group) and 34 cases underwent conventional laparoscopic left hemihepatectomy (conventional group). The perioperative conditions and complications, and the serum albumin (ALB), aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin (TBIL), α-fetoprotein (AFP), thromboplastin time (APTT), fibrinogen (FIB), prothrombin time (PT) before surgery and 3 d and 1 month after surgery as well as the follow-up data were compared between the two groups of patients.Results There were no statistical differences in preoperative data and liver function parameters between the two groups of patients (all P>0.05). The average intraoperative blood loss of the LUS group was significantly lower than that of conventional group (322.64 mL vs. 395.94 mL, P<0.05). There were no statistical differences in terms of the operative time, distance from the cutting edge to the lesion, time for postoperative drainage tube retention, time to anal gas passage, and length of hospital stay between the two groups (all P>0.05). Middle hepatic vein injury occurred in none of the patients in LUS group, and occurred in 5 patients (14.71%) in conventional group, the difference was statistically significant (P<0.05). The incidence rates showed no statistical difference between LUS group and conventional group (13.33% vs. 23.53%, P>0.05). There were no statistical differences in APTT, FIB and PT as well as the ALB and AFP levels between the two groups on 3 d and 1 month after the surgery (all P>0.05); the ALT, AST and TBIL levels of LUS group were significantly lower than those of conventional group on 3 d after surgery (all P<0.05), which showed no significant differences on 1 month after surgery (all P>0.05). The median follow-up time was 13.5 (9-18) months. the recurrence and the mortality rates showed no statistical differences between LUS group and conventional group (10.00% vs. 17.65%, P=0.483; 3.33% vs. 5.88%, P=0.999).Conclusion The LUS left hemihepatectomy is safe and effective for the treatment of PLC, its short-term prognosis is similar to that of conventonal laparoscopic left hemihepatectomy. However, LUS is more effective for reducing intraoperative bleeding and protecting liver function in the early stage.