Abstract: Objective To explore the diagnosis and surgical treatment of hilar cholangiocarcinoma. Methods and Results Of 102 patients with hilar cholangiocarcinoma, 21 (20.6%) underwent surgical exploration and biopsy with an average survival time of 72 d, 18 (17.6%) received drainage with that of 8.3 months, and 63 (61.8%) were subjected to surgical resection and anastomosis with that of 25.7 months. The surgical approaches included resections of the perihepatic cholangiocarcinoma, of the quadrate lobe and outer bile ductule carcinoma, of the left half of the liver, of the caudal lobe and outer bile ductule carcinoma, and Roux-en-Y ligation of the intraheptic bile ductule-jeajunum. Conclusions Resection is a the primary choice for treatment of hilar cholangiocarcinoma, and radical resection may prolong the patients’ survival time and achieve better effect than simple drainage. In cases where resection is impossible, jaundice management should be carried out.