Abstract: Objecitve: To analyze surgical management and prognosis of hilar cholangiocarcinoma (HCC). Methods: Clinical data of 67 HCCs were retrospectively analyzed. Results: There was a significant difference in the cumulative survival rates among the groups treated with different surgical methods (P<0.001). The 1- and 3-year survival rates were significantly higher in the radical excision (RE) group than in the alleviated treatment (AT) and simple drainage (SD) groups, and there was an apparent improvement in the RE group compared to the non-resection groups (P<0.001). Preoperative evaluation of the T staging and Bismuth-Corlette typing could guide the decision for which surgical method would be best. There was a significant difference between the surgical removal rate and the negative incisal edge gin of various T stages (P<0.001,P=0.032). Results of the univariate analyses conducted for the 16 factors which may affect prognosis showed that tumor size, invasion of the portal vein, local infiltration and metastasis, surgical method, UICC staging and modified T stage, as well as lymphatic metastasis, were of prognostic value with statistical significance (P<0.05). Surgical management and the TNM staging were the two independent prognostic factors based on a multivariate analysis of the Cox Proportional Hazards Model. Conclusions: Radical excision is the most important prognostic factor for HCCs and an enlarged area of resection could improve the success rate of radical surgery. Preoperative evaluation of T staging and Bismuth-Corlette typing could also be helpful for improving the success rate.