Hepatic arterial infusion chemotherapy (HAIC) for liver metastases from digestive cancer has passed through a long history. In spite of its significant high tumor reduction rate, this therapeutic modality has been rejected as the first-line therapy for liver metastases from colorectal cancer because of the negative results of RCTs compared to systemic chemotherapy. However, recently some excellent results have been reported by the combination with systemic chemotherapy,and a positive result of RCT using a satisfactory study design has been reported. Thus, the combination with systemic chemotherapy and RCT in comparison with modern standard systemic chemotherapy as the first-line therapy remains an important problem to be solved. On the other hand, the highly-developed technology for HAIC using techniques of interventional radiology has been standardized in Japan. Thus, we now have become the closest in the world to performing good-quality clinical trials of HAIC supported by high-quality technology. We should therefore consider our very important role in resolving such problems and deciding the future of HAIC.