To investigate the value of intraoperative ultrasound-guided liver segment staining for hepatic segment VIII (S8) resection. Methods The clinical data of 31 patients with primary hepatocellular carcinoma with tumor location in S8 were retrospectively analyzed. Firstly, the hepatic S8 portal vein branches were stained under intraoperative ultrasound guidance, followed by marking the incision line along the stained area on the surface of the liver using an electric knife, and finally the stereoscopic precise S8 resection was completed, and the right hepatic vein, the lateral wall of the main trunk of the middle hepatic vein and the hepatic tip of S8 were revealed in the postoperative liver isolation section. Results All 31 patients underwent precise S8 resection with a mean operative time of (230±76) min, mean operative bleeding of (305±235) ml, postoperative complication rate of 26% (8/31), mean postoperative hospital stay of (13±3) d, 1-year recurrence rate of 19% (6/31) and 1-year survival rate of 94% (29/31) after surgery. Conclusion The use of intraoperative ultrasound guidance with liver segment staining can improve the precision of anatomical S8 resection and is the best procedure for S8 tumor resection. The postoperative recovery is fast and the recurrence rate is low. With the continuous updating and improvement of liver resection technology, the evaluation of surgical quality has changed from one-sided emphasis on complete removal of lesions and simple pursuit of surgical speed to a multi-dimensional consideration of “minimal invasion, maximum organ protection and best recovery effect”, and the traditional crude surgical model is quietly changing to a modern precise surgical model1-2. -Accurate anatomical resection of liver segments has become the highest goal for hepatic surgeons, especially for tumors located in S8 and its subsegments of the liver, and how to achieve accurate surgical resection has been a difficult task in the field of liver surgery, which has not been reported in China. In this paper, we retrospectively analyzed the clinical data of 31 patients with primary liver cancer who underwent precise S8 resection after intraoperative ultrasound-guided S8 staining in 302 hospital from October 2009 to August 2011, and explored the value of this method in precise S8 resection.