【Abstract】 Objective To investigate the prognostic factors of hilar cholangiocarcinoma with concomitant hemihepatectomy. Methods The clinical data of 63 patients with hilar cholangiocarcinoma underwent concomitant hemihepatectomy at The First Affiliated Hospital of Xi’an Jiaotong University from January 2003 to December 2013 were retrospectively analyzed．There were 35 males and 28 females, aged 2577 years old. Surgical procedures were determined according to the results of imaging examination. The resection of hilar cholangiocarcinonia and prognostic indicators were analyzed. The count data and measurement data were analyzed using the chisquare test and t test, respectively; the survivaI rate was analyzed using the Logrank test; KaplanMeier method was used for univariate analysis and COX proportion hazards model was used for multivariate analysis．Results All patients were examined by B ultrasonography, computed tomography (CT), magnetic resonance cholangiopancreatography (MRCP) and CT angiography (CTA), preoperatively. The hepatic function was tested before operation. Of the 23 patients with obstructive jaundice, 11 received percutaneous transhepatic cholangial drainage (PTCD), and 12 received endoscopic nosalbiliary drainage (ENBD). Concomitant left hemihepatectomy was performed on 35 patients, concomitant right hemihepatectomy on 20 patients, concomitant left hemihepatectomy and portal vein reconstruction on 5 patients, concomitant right hemihepatectomy and portal vein reconstruction on 2 patients, concomitant left hemihepatectomy and pancreaticoduodenectomy on 1 patient. Of the 63 patients, R0 resection was performed on 55 patients, R1 resection on 8 patients. Hepatic function indicators including total bilirubin were significantly decreased after operation(P＜005). The overall 1, 2, 3year survival rates were 81%，46%and 31%, and the median survival time was 235 months. The results of multivariate analysis showed that R0 resection and lymph node metastasis were prognostic indicators(P＜005). Conclusion R0 resection has significantly improved the prognosis of hilar cholangiocarcinoma. Comprehensive preoperative assessment, precise intraoperative assessment again and subtle intraoperative procedure are important for improve R0 resection of hilar cholangiocarcinoma．