Objective 　To analyze the effectiveness and safety of surgical resection and radiofrequency ablation therapy in treatment of primary liver cancer meeting the Milan criteria. Methods 　The clinical data of 105 cases of primary liver cancer meeting the Milan criteria in 302 Hospital from Dec. 2010 to Jul. 2012 who were treated respectively by surgical resection or radiofrequency ablation therapy were retrospectively reviewed. The postoperative survival rate, tumor-free survival rate, complications, and hospital stay days were compared between two groups. Results 　Patients were divided into single pure group (n=73) and multiple combined group (n=32). The total survival rate and total tumor-free survival rate 3 years after therapy were higher in those patients received surgical resection than in those received radiofrequency ablation in both single pure group and multiple combined group (P<0.05). The incidence of major complications resulted in radiofrequency ablation was obviously lower than that in surgical treatment (P<0.05). Radiofrequency ablation therapy had the advantages of short hospitalization time, rapid recovery, etc. Conclusions 　Surgery gives better result in the treatment of primary liver cancer meeting Milan criteria, especially its long-term effect is better than that of radiofrequency ablation. DOI: 10.11855/j.issn.0577-7402.2016.03.10