Abstract: Objective:To discuss the role of incision for short-term outcomes of simultaneous resection in synchronous colorec -tal liver metastases (sCRLM). Methods:We reviewed the data of 37patients who underwent simultaneous resection between January 2009and December 2014in our department and compared the short-term outcomes between Mercedes and midline incisions. Results: Mercedes and midline incisions were used in19and 18patients, respectively. The two groups showed similarities in patient characteris -tics, major hepatectomy, surgery time, blood loss, and hilar block time. The midline group comprised more rectal cancer patients( P<0.001). The two groups did not differ significantly in complication incidence ( 47.4% vs.16.7 %,P=0.08) and postoperative stay time (22.1 ± 9.5 d vs.17.2 ± 6.7 d, P=0.08). At body mass index (BMI) < 25, the complication incidence (P=0.046) and postoperative stay time ( P=0.051) were lower in the midline group than in the Mercedes group. Conclusion:Midline incision provided similar exposure in simultaneous resection for sCRLM and was better than Mercedes incision in rectal cancer patients. Patients with midline incision may attain better short-term outcomes if BMI is<25.