The incidence of primary and metastatic liver tumors is rising and the therapeutic armamentarium for these tumors is expanding at a rapid pace. Surgery remains the primary treatment modality for these tumors. With improvements in our perioperative management and operative techniques a larger proportion of patients are able to undergo potentially curative liver surgery. In addition, indications and criteria for liver transplantation for both primary and metastatic liver tumors are constantly expanding. Unfortunately, many patients are not amendable to surgical resection or liver transplantation and therefore alternative liver-directed therapies are routinely being implemented as part of complex multidisciplinary treatment models. However, these models are continually evolving as these regional therapeutic options continue to expand.