Objective To investigate the safety,feasibility,and efficacy of total laparoscopic hepatectomy in the treatment of hepatocellular carcinoma( HCC) in the left lateral lobe. Methods A case- matched analysis was performed between 25 patients with HCC in the left lateral lobe confirmed by postoperative pathological examination,who were admitted to Panzhihua Central Hospital and underwent total laparoscopic left lobe resection( LLLR) from April 2012 to April 2015,and 25 patients with HCC who underwent open left lobe resection( OLLR)during the same period. The t- test was used for comparison of continuous data between the two groups,and the chi- square test or Fisher's exact test was used for comparison of catagorical data between the two groups; the Kaplan- Meier method was used for survival analysis,and the log- rank test was used for comparison of survival curves. Results The time of operation,number of patients undergoing intraoperative blood transfusion,and number of patients with R0 resection margin showed no significant differences between the LLLR group and the OLLR group,but intraoperative blood loss( 216. 4 ± 15. 39 ml vs 273. 2 ± 16. 65 ml),mean hospital stay( 6. 92 ± 0. 29 min vs 10. 32 ±0. 52 min),and postoperative complications( 5 cases vs 12 cases) showed significant differences between the two groups( all P < 0. 05).The 1- and 3- year overall survival rates and progression- free survival showed no significant differences between the LLLR group and the OLLR group. Conclusion LLLR and OLLR have similar long- term efficacy in the treatment of HCC in the left lateral lobe,and LLLR has advantages in the aspects of intraoperative blood loss,postoperative complications,and length of hospital stay.