Open right and left hepatectomy are common yet potentially challenging operations that require careful preoperative planning and intraoperative technique to be performed safely. Careful attention to preoperative planning, including accurate measurement of the FLR and selective use of PVE, HVE, or Y-90, is crucial for patient selection. However, a thorough knowledge of the vascular anatomy of the liver and meticulous surgical technique on the part of the surgeon remain essential to mitigating severe complications. This chapter reviews our approach to open hemihepatectomy at The University of Texas MD Anderson Cancer Center.