Anatomical liver resection is currently the preferred treatment for liver cancer. With the recent introduction of medical microwave coagulation for liver metastases, anatomical hepatectomy may be performed more efficiently. The present study retrospectively reviewed the results of microwave tissue coagulation performed during anatomical liver resection for patients with liver disease at the TangDu Hospital (Xi'an, China) between January, 2009 and June, 2012. A total of 128 patients met the inclusion criteria and were divided into two groups for comparison; those treated with the microwave coagulation technique (n=66) and the conventional group (n=62), who were treated with standard partial hepatectomy. There was no reported perioperative mortality. The univariate analysis revealed that the duration of liver dissection, intraoperative blood loss, intraoperative erythrocyte transfusion volume and alanine aminotransferase levels on the 5th postoperative day were significantly different between the microwave and conventional groups (P<0.05). Therefore, microwave tissue coagulation in anatomical liver resection was shown to be efficacious and safe and, provided proficient skills are developed in this technique, microwave tissue coagulation may be an effective alternative to anatomical hepatectomy.