As a revolutionary surgical procedure in liver surgery in recent 10 years, associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) ligatures the portal vein on the deportalized lobe (DL) of the liver and separates the liver tissue on the DL from the residual liver tissues at the same time, so that the healthy side can regenerate rapidly within 1–2 weeks. As the future liver remnant (FLR) grows enough, the DL can be removed in the second stage, which allows patients with liver cancer that could not be resected to regain the opportunity for radical resection. However, the surgical operation during ALPPS and the drastic change of microenvironment during the rapid liver regeneration may lead to high local recurrence and distant metastasis after ALPPS (the recurrence/metastasis rate within 1 year after surgery has been reported to be approximately 54.0% [1]), which affects the prognosis and quality of life of patients after ALPPS. This chapter summarizes the influence of ALPPS on tumor recurrence and metastasis and explores its prevention and treatment strategies based on the current research data and experience.