Objective: To investigate the efficacy of anatomic right trisegmentectomy for huge or multifocal right hepatic hepatocellular carcinoma (HCC). Methods: Twelve patients with huge or multifocal right hepatic HCC tumors underwent anatomic right trisegmentectomy with preservation of segment V or VIII, in whom the preoperative CT-based liver volumetry suggested that the percentage of future liver remnant volume (%FLRV) would be insufficient for them after right hemihepatectomy, which could be increased by an average of 14.3% by right trisegmentectomy instead. During operation, the segment V or VIII was identified by use of selective hepatic inflow occlusion, and then a “ ┏┛ ” or “ ┕┓ ”shaped resection line was marked on the diaphragmatic surface of the liver; right hemihepatic or total hepatic inflow occlusion was used according to different resection plane to avoid ischemia/reperfusion injury during parenchymal transection. Results: Anatomic right trisegmentectomy was successfully completed in all patients, with an average operative time of 285 min and intraoperative blood loss of 720 mL. The tumors in all patients were completely resected, the inflow and outflow of segment V or VIII remained intact, no perioperative death occurred, and AFP level in all patients returned to normal range within 2 months after operation. Of the whole group of 12 patients, 10 cases were alive so far with a longest tumor-free survival for 3 years in one case; one case died of obstructive suppurative cholangitis, and one case died of multiple intrahepatic metastases and liver failure, while one case with left hepatic recurrence and 2 cases with lung metastases lived with tumor under comprehensive therapy, but in the remaining cases, no tumor recurrence or metastasis occurred, and liver function parameters and AFP level were in normal ranges. Conclusion: Anatomic right trisegmentectomy guarantees the maximum preservation of remnant functional liver tissue, so it can be a conventional operation for patients with huge or multifocal right hepatic HCC without segment V or VIII involvement, and thereby improves the overall resection rate of HCC.