Hepatoportal cholangiocarcinoma is a malignant tumor that occurs in the narrow area from the left and right hepatic ducts to the common hepatic duct, accounting for 50% to 60% of cholangiocarcinoma. The early symptoms of hilar cholangiocarcinoma are insidious, and the diagnosis is often obtained only at the progressive stage. It is of great significance to accurately determine the resectability of hilar cholangiocarcinoma before surgery to avoid unnecessary surgical exploration and reduce the pain of patients. Under the condition that the patient’s general condition and vital organ functions can tolerate surgery, the resectability of hilar cholangiocarcinoma is mainly determined by the following five aspects: the extent of longitudinal invasion along the bile duct, the extent and degree of transverse invasion (vascular invasion), whether it is combined with lobe atrophy, lymph node metastasis and distant metastasis. In recent years, with the development and improvement of medical imaging technology, the assessment results of these five aspects by preoperative imaging are an important basis for determining the resectability of hilar bile duct cancer. Radical surgical resection is an effective cure for hilar cholangiocarcinoma, but accurate preoperative resectability assessment is still a challenge.