Abstract: Purpose To discuss the application of limb ischemic preconditioning before liver resection and the hepatic portal ischemic preconditioning induce autophagy to reduce liver ischemia reperfusion (IR) injury in patients with hepatectomy. Methods One hundred and sixty liver cancer patients with hepatectomy in our department were chosen from June 2016 to June 2019. 40 cases with normal liver resection was as the control group; 40 cases undergoing limb ischemia preconditioning before liver resection were as the experimental group 1; 40 cases undergoing hepatic portal ischemic preconditioning before liver resection were as the experimental group 2; and 40 cases undergoing limb ischemia preconditioning and hepatic portal ischemic preconditioning before liver resection were as the experimental group 3. Liver damage (liver HE staining and liver function analysis) were monitored before and after operation; autophagy and apoptotic protein in liver tissue was detected by western blotting, and the intraoperative condition, postoperative complication rate as well as the hospital stay were compared. Results Liver function: the values in the experimental groups was lower than the control group, and the values in the experimental group 3 was significantly lower than the experimental group 1 and 2; Autophagy protein：The ex＜x＞pression of autophagy protein was more higher in the experimental groups than the control group, and it was the most highest in the experimental group 3. Apoptotic protein: the values of apoptotic protein in the three experimental groups was lower than that in the control group, and it was the most lowest in the experimental group 3; Liver HE staining：it showed more degrees of necrosis, fatty degeneration in the experimental groups compared with the control group, and the liver HE staining scores was lower in the experimental group 3 than the experimental group 1 and 2; No significant difference of the intraoperative bleeding and hospitalization time were showed in all the groups; and no significant difference of the postoperative complications were showed in all the experimental groups. Conclusion Limb ischemic preconditioning or hepatic portal ischemic preconditioning could induce autophagy to alleviate the liver IR injury in patients with hepatectomy, and the limb ischemic preconditioning combined with the hepatic portal ischemic preconditioning has a more significant effect on liver function remission than limb ischemic preconditioning and hepatic portal ischemia preconditioning alone, which benefit for the protection of liver injury in patients with hepatectomy and provides a new way to reduce the liver IR injury in clinical.