Liver resection for hilar cholangiocarcinoma remains challenging because of the occurrence of unanticipated vascular and longitudinal bile duct invasion. Operative strategies to achieve negative resection margins often vary depending on the status of vascular invasion. Accurate preoperative assessment of vascular invasion is the most important part toward macroscopic curative resection. First of all, right hepatic artery invasion is one of the most common findings and surgeons have to determine whether the right hepatic artery will be dissected successfully or not. If it appears to be not dissectable due to long or definite involvement, it is an eligible indication for sacrifice of the right liver. Thus preoperative portal vein embolization is often applied to such situations. In contrast, if the future remnant liver appears to be too small to induce sufficient liver regeneration even following preoperative portal/hepatic vein embolization or if the left liver is directly involved, the left liver should be resected with reconstruction of the right hepatic artery. The inflow sources for right hepatic artery are usually the gastroduodenal artery and rarely right gastroepiploic artery. The right gastroepiploic artery is a very useful source for various situations of arterial reconstruction because it provides a long length and easily expansible diameter. When the right hepatic artery is involved thus its resection is decided, it is reasonable to apply anterior approach, which enables minimal dissection of the perihilar area. The pattern of portal vein invasion is diverse and can be divided into 3 types depending on the grades of portal vein reconstruction. Focal invasion is an indication for wedge resection and primary repair. However, it requires a hemodynamically compliant design, thus its successful application is more difficult than expected. Second, segmental resection of the portal vein and primary end-to-end anastomosis is a preferred method, especially during right liver resection. Third, vein graft interposition should be taken into account. Homologous iliac/femoral vein is the best substitute, but spiral winding of the autologous saphenous vein can be a safe option. The prognosis of hilar cholangiocarcinoma can be improved through local tumor control, thus macroscopic curative resection with combined vascular reconstruction is highly recommended. In contrast, if the tumor is far locally advanced and involved with extensive regional lymph node metastasis, it may be beyond the territory of surgical resection. Accurate assessment and meticulous planning of surgical treatment will lead to provide the highest benefit to the patients with locally advanced hilar cholangiocarcinoma.