Portal vein ligation (PVL) is a surgical technique used to induce hypertrophy of the future liver remnant. Its main indication includes patients undergoing two-stage hepatectomy (TSH) for bilobar colorectal liver metastases (CRLM). Indeed, in such cases, PVL can be performed intraoperatively during the first stage of resection, offering the advantage of avoiding a second percutaneous procedure. PVL, especially when combined with absolute alcohol injection, can achieve comparable results to percutaneous portal vein embolization (PVE). PVL remains a valid option, particularly in patients with favorable portal anatomy or when PVE is technically unfeasible. However, potential drawbacks include periportal fibrosis that may complicate the second-stage surgery, especially in laparoscopic approaches. Careful patient selection and technical considerations are essential to optimize outcomes with PVL in the TSH setting.