Intrahepatic cholangiocarcinoma (ICC) has the significant characteristics of regional spread and lymphatic metastasis. Radical resection provides the only chance for long-term survival of patients with ICC. Anatomic or extended hepatectomy is the most optimal treatment. The value of hepatic resection with lymph node dissection and the area of lymph node dissection are controversial. Palliative resection improves prognosis of some patients. Secondary hepatectomy also benefits some patients with late (＞1 year) intrahepatic recurrence. Liver transplantation is only performed for highly selected prophase-patients or prudent clinical trials, and a combination with adjuvant treatment such as chemo-radiotherapy after operation is suggested.