Secondary hepatocellular carcinoma is also known as metastatic hepatocellular carcinoma. Liver is the most common organ of bloodstream metastasis, and autopsy confirms that metastatic liver cancer accounts for 41% of various metastatic tumors. Among them, 57% come from primary tumors of the digestive system, especially colon and rectum are prone to occur. For colon and rectal cancer with liver metastasis only, there is a possibility of long-term survival or even cure after radical resection. Other primary cancers with liver metastasis include lung cancer, breast cancer, pancreatic cancer, gastric cancer, gallbladder cancer, extrahepatic bile duct cancer, kidney cancer, cervical cancer, ovarian cancer, prostate cancer and head and neck tumors, etc. Most of them are accompanied by extrahepatic metastasis, so the role of surgery is limited. Secondary hepatocellular carcinoma is often manifested mainly by the symptoms caused by extrahepatic primary tumors, while metastatic liver cancer nodules are usually asymptomatic when they are small, and are often detected only during laboratory or imaging examinations. Even a few patients diagnosed with metastatic liver cancer cannot find the primary lesion outside the liver. With the increase of metastatic lesions, discomfort or vague pain in upper abdomen or liver area may appear, and when the disease develops, weakness, fever and weight loss may appear. On physical examination, enlarged liver or hard cancer nodules can be found and palpated. Imaging examinations such as ultrasound, CT, MRI and PET have important diagnostic value. Tumor markers: CEA, CA19-9, CA125, etc. have diagnostic value for liver metastasis of gastric cancer, colorectal cancer, gallbladder cancer, pancreatic cancer, lung cancer, ovarian cancer, etc. AFP test is often negative. Secondary hepatocellular carcinoma should be treated according to the treatment of the primary tumor, and comprehensive treatment should be planned. The treatment of liver lesions is similar to that of primary liver cancer. If the metastatic cancer lesions are isolated or multiple but confined to one lobe or one segment of the liver, and the primary tumor has been removed, lobectomy should be preferred if the patient’s general condition allows and there is no metastasis from other parts of the liver. If both primary and secondary hepatic tumors are found at the same time and both are resectable and eligible for hepatic resection, then simultaneous or staged surgery with the primary tumor can be adopted according to the patient’s tolerance. Intraoperative ultrasound examination can help to detect new lesions in the liver, so that the original surgical plan can be modified. For secondary liver tumors that are not suitable for surgical resection or those found to be inoperable, according to the patient’s general and primary tumor, local treatments such as hepatic artery chemoembolization, anhydrous alcohol injection, radiofrequency ablation and freezing can be used for liver metastases according to the location and number of cancer foci, etc. The above local treatments can also complement each other with surgical resection and may expand the scope of surgery. The above local treatments can also be complemented with surgical resection, and it is possible to expand the scope of surgery. The prognosis is related to the nature of the primary cancer, the severity of the primary and secondary cancer at the time of detection, and the response to treatment. In general, the outcome after resection of secondary liver cancer is generally poor. However, colorectal cancer with only liver metastasis, no extrahepatic tumor recurrence or other metastatic lesions, and the possibility of radical resection, is expected to have long-term survival or even the possibility of cure. The perioperative mortality rate is <5%, and the 5-year survival rate is 25%-46%. Surgical principles: remove the lesion as much as possible and preserve the maximum amount of healthy liver tissue. The curability of the patient should be evaluated before surgery: colonoscopy to exclude local recurrence or the appearance of new lesions; chest X-ray, CT of the abdomen and pelvis; PET/CT scan is expected to detect more obscure lesions. The presence of extrahepatic tumor lesions, inability to obtain a negative tumor at the cut margin by liver resection, and having more than four liver metastases are considered as contraindications to surgery. After resection of liver metastases from colorectal cancer, about 50% of recurrences are still confined to the liver; the 5-year survival rate after second surgical resection can still reach 30%-40%, therefore, CEA test and ultrasound and other imaging examinations should be performed regularly after surgery to detect lesions as early as possible and strive for the chance of another surgical treatment. Small intestine carcinoid tumors and neuroendocrine carcinoma of the stomach and pancreas with liver metastases are easily resected and can relieve symptoms and survive for a long time. Patients with metastatic carcinoid tumors and neuroendocrine carcinoma of the liver can undergo liver transplantation after strict selection. Metastatic carcinoid tumor liver transplantation can also achieve good results, with a reported 5-year survival rate of 69%.