In patients with multiple hepatocellular carcinomas (HCCs), a liver resection for the main tumor may be performed in combination with local ablation therapy for satellite lesions. Of 63 multiple HCC patients without radiological vascular invasions, 27 were treated with liver resection alone and the other 36 treated with the combination of liver resection and local ablation therapy. No significant differences were found in both groups with regard to age, gender, BMI, etiology of hepatitis, liver damage grade, tumor number, size of the main tumor and size of satellite lesion. In the liver resection group, 11 hemihepatectomies, 12 sectionectomies and 4 partial hepatectomies were performed. In the combination therapy group, 8 hemihepatecomies, 17 sectionectomies and 11 partial hepatectomies were performed. No significant differences were found in both groups with respect to bleeding, transfusion, disease-free survival rate, and survival rate. In the combination therapy group, a resected liver volume was significantly lower (p = 0.003) and an operation time was shorter (p = 0.009). It appears to indicate that the combination of liver resection and local ablation therapy can be useful for multiple HCCs.