Depending on the patient’s condition, the following options are available: 1) hepatectomy; 2) cystectomy; 3) cyst openings or major cyst excision; 4) cyst internal drainage; 5) cyst puncture and fluid aspiration and sclerosis. In case of complications such as cyst rupture, cystic torsion or intracapsular hemorrhage, in addition to emergency surgery, elective surgery is needed depending on the size and location of the cyst and the patient’s general condition and conscious symptoms, and regular observation using ultrasonography, which requires vigilance against the occurrence of malignant changes. Polycystic liver should usually be treated non-surgically, as its lesions involve the whole liver, the disease cannot be cured unless liver transplantation is used. However, surgery should be considered to reduce the pressure once the hepatomegaly compresses the chest and abdomen and affects the respiratory circulation. Surgery for polycystic liver: Unless the lesion is confined to one lobe of the liver and is symptomatic; or if malignancy is suspected, surgery is generally not advocated. In polycystic liver, when individual cysts are found to be rapidly enlarging and compressing the adjacent organs, seriously affecting the patient’s daily life or cardiopulmonary function, repeated puncture and aspiration can be performed on the larger cysts. If the patient is in good general condition and has normal liver function, open-heart surgery can also be performed to reduce pressure, relieve symptoms and promote regeneration of liver cells. If possible, liver transplantation can be performed to completely cure the disease. Treatment of polycystic liver combined with polycystic kidney: It includes puncture or incision of the cyst to reduce the pressure of the cyst, which can sometimes delay the progression of the lesion and renal failure, and dialysis therapy if necessary. The radical cure requires kidney transplantation.