Objective To investigate the clinical result of radical resection of hilar cholangiocarcinoma combined with left hepatectomy and resection of ventral segment of right anterior sector. Methods The data of one patient diagnosed as hilar cholangiocarcinoma and treated with radical resection combined with left hepatectomy and resection of ventral segment of right anterior sector was analyzed in Beijing Tsinghua Changgung Hospital in November 2019, and the literatures associated with anatomy and surgery of right anterior sector of liver were reviewed. Results This was 74-year-old female diagnosed as Bismuth type Ⅳ hilar cholangiocarcinoma after preoperative image. She had radical resection successfully combined with left hepatectomy and resection of ventral segment of the right anterior sector. The operative time was 11 h 23 min with 300 mL intraoperative bleeding. The postoperative course was smooth and patient discharged on the 17th day after operation. Conclusions Compared with left trisectionectomy in the radical resection of hilar cholangiocarcinoma, left hepatectomy combined with resection of ventral segment of right anterior sector could preserve more functional liver vo-lume effectively while radical resection of the target lesion and avoidance of postoperative liver failure.