The liver is the most common site of metastases from various tumours situated anywhere in the body, particularly of those caused by colorectal tumours. Its role as the primary collector of all substances from the digestive system makes the liver a highly attractive target for malignant cells. A third of the patients already present with liver metastases at the time they are diagnosed with primary colorectal tumour, in another third they will be detected during patient follow-up, while in the remaining third they will never develop. The status of metastatic disease in such patients is key to determining the course of treatment and the prognosis. Today, thanks to the technological advances and to the general progress of all branches of medicine, we have at our disposal a wide array of approaches to and modalities of treatment of liver metastases, but the role of classical surgery is still crucial. Even within classical surgery there are a number of tumour tissue removal (i.e. resection) procedures. Recent insights into the physiology of the liver and the behaviour of malignant cells have greatly impacted the classical operative methods, also increasing the survival rates and improving the patients’ quality of life. It is important to note that despite these advances the principle of individuality has to be respected, and each patient has to be approached specific to his or her needs. Complementary methods such as portal vein embolisation and portal vein ligature have also improved the results of surgical treatment, and in some cases have converted inoperable cases into operable ones. As a result of new discoveries in pharmacology and of the development of a large number of the so-called “smart drugs”, the chemotherapeutic treatment of tumours has also improved. Together with complementary methods such as radiofrequency ablation, today a palliative approach to liver metastases treatment is possible, improving the quality of the remaining lifetime for terminal patients, which a couple of decades ago was not the case. In the near future, minimally invasive and laparoscopic approaches to liver metastases and malignant diseases in general will be made possible; we discuss these in the present paper. Finally, it should be emphasised that surgery has been the curative method of choice for liver metastases, while all the other methods are purely complementary and as such are to be applied in combination with surgical treatment, never as alternatives to surgery.