Objective To observe the clinical efficacy of precision hepatectomy for primary liver cancer （PLC）. Methods A total of 104 PLC patients admitted to the Department of Hepatobiliary Surgery, Affiliated Hospital of Putian University from June 2019 to June 2021 were randomly divided into an observation group and a control group. The control group received traditional liver resection, while the observation group received precision hepatectomy. Operation related indexes, liver function before and after treatment, and surgical complications in the two groups were compared. Results The amount of intraoperative bleeding and postoperative hospitalization days in the observation group were less than those in the control group （P<0.05）. There was no significant difference in liver function indexes between the two groups before operation （P>0.05）, and the values of the main liver function indexes in the two groups after operation were higher than those before operation, but the increment values in the observation group were lower than those in the control group （P<0.05）. The incidence rates of postoperative biliary leakage, ascites, and other complications in the observation group were lower than those in the control group （P<0.05）. Conclusion Precision hepatectomy for PLC can significantly reduce intraoperative bleeding, promote postoperative recovery, reduce the damage of liver function, and has fewer complications, showing significant efficacy.