Abstract: Objective: To investigate the causes for low resection rate and high postoperative recurrence rate in the young patients with primary liver cancer ( PLC). Methods: A total of 173 patients with PLC during Jan 1985 to Jan 2000 were allocated to the youth group (≤35y, n=83) and the middle and older age-group (≥36y, n=90). The clinical data, resection rate, postoperative recurrence rate and survival rate were compared and analyzed. Results: The resection rate and 1-year postoperative recurrence rate were 26, 51%, 53.33% and 68.18%, 37.50%, and the 1-, 3- and 5-year cumulative survival rate were 59.09% and 81.25%, 22.73% and 47.92% and 9.09% and 39.58% in two groups. The prognosis was worse than that in the middle and older age-group (P<0.01). Conclusion: Quick growth, strong invasiveness, more portal vein tumor thrombi, massive and diffuse liver cancer are the features of young patients with PLC. These are also the causes for low resection rate and high recurrence rate in young patients. The early diagnosis helps to promote the resection rate and decrease the rate of postoperative recurrence.