Objective: To investigate the efficacy of using liver hanging maneuver (LHM) in associating liver partition and portal vein ligation for staged hepatectomy (ALPPS). Methods: The clinical data of 4 patients with primary liver cancer undergoing ALPPS procedure were retrospectively analyzed. Of the patients, 3 cases had tumor in the right lobe and one case in the caudate lobe. All patients underwent first-stage operation of in situ splitting of the liver parenchyma and right portal vein ligation guided by LHM, and a second-stage of complete tumor removal. Results: In all the 4 patients, the prior hepatic transection, hanging tape positioning and second-stage liver resection were performed successfully. In the first-stage operation, the operative time was 195–273 (232.2±35.3) min, intraoperative blood loss was 420–1 210 (735±344.3) mL, and bile leakage occurred in one case; in the secondstage operation, the operative time was 98–186 (139.5±36.6) min, and intraoperative blood loss was 100–320 (197.5±95.3) mL. No operative death occurred. The patients were followed-up for 3 months, at which time 3 patients were in good condition, and one patient had died of recurrence 2 months after operation. Conclusion: LHM is effective for inferior vena cava protection and clear exposure of the intrahepatic blood vessels and ductal system, so it can be routinely used in ALPPS procedure.