Liver metastasis represents the major cause of death of patients who havebeen treated for colorectal adenocarcinoma. Spontaneous survival rarelyexceeds two years. Surgery can offer long-term survival and resection shouldbe considered when liver metastases can be totally resected with clear marginsand when there is no non-resectable extra-hepatic disease. The choice betweenanatomical or wedge resection depends on the number and the location of themetastases but does not influence survival. Clamping methods limit blood loss.Operative mortality is generally less than 5%. The five-year survivalrate after surgical resection varies from 20% to 45% accordingto several prognostic factors. The longer survival is observed in patientswith fewer than four lesions, with lesions smaller than 4 cm, withoutextra-hepatic disease, with lesions that appeared more than two years afterthe resection of a stage I or II colorectal cancer and whose CEA level isnormal. After resection, follow-up can detect hepatic recurrence that can betreated with repeat hepatectomy. The efficacy of systemic chemotherapy usingnew agents can increase the number of patients amenable to surgery. Regionaltherapies with cryotherapy or radiofrequency ablation can help to treatunresectable or non-totally resectable lesions and may improve survival. Theeffects on survival of adjuvant treatments, including pre- or postoperativesystemic or postoperative intra-arterial chemotherapy, are currently underevaluation.