With the development of comprehensive treatment for hepatocellular carcinoma, conversion therapy has provided surgical opportunities for patients with unresectable hepatocellular carcinoma; however, liver resection after conversion faces the core challenge of changes in the fine anatomical structure of the liver and systemic status. It is necessary to systematically analyze the impact of conversion therapy on hepatic anatomy, as well as the difficulties and countermeasures in liver resection, from the anatomical perspective, especially the impact of future liver remnant conversion and oncological conversion therapy on the whole body and the liver. Implementing the comprehensive strategy involving precise preoperative evaluation, optimization of surgical timing, intraoperative meticulous operation, and multidisciplinary collaboration is proposed, can enhance surgical safety and oncological efficacy.