Background: There is an ongoing debate on the feasibility, safety, and oncological efficacy of the associ- ating liver partition and portal vein ligation for staged hepatectomy (ALPPS) technique. The aim of this study was to compare ALPPS, two-staged hepatectomy (TSH), and portal vein embolization (PVE)/ligation (PVL) using updated traditional meta-analysis and network meta-analysis (NMA).Data sources: Electronic databases were used in a systematic literature search. Updated traditional meta- analysis and NMA were performed and compared. Mortality and major morbidity were selected as pri- mary outcomes. Results: Nineteen studies including 1200 patients were selected from the pool of 436 studies. Of these patients, 315 (31％) and 702 (69％) underwent ALPPS and portal vein occlusion (PVO), respectively. Ninety- day mortality based on updated traditional meta-analysis, subgroup analysis of the randomized controlled trials (RCTs), and both Bayesian and frequentist NMA did not demonstrate significant differences between the ALPPS cohort and the PVE, PVL, and TSH cohorts. Moreover, analysis of RCTs did not demonstrate sig- nificant differences of major morbidity between the ALPPS and PVO cohorts. The ALPPS cohort demon- strated significantly more favorable outcomes in hypertrophy parameters, time to operation, definitive hepatectomy, and R0 margins rates compared with the PVO cohort. In contrast, 1-year disease-free sur- vival was significantly higher in the PVO cohort compared to the ALPPS cohort. Conclusions: This study is the first to use updated traditional meta-analysis and both Bayesian and fre- quentist NMA and demonstrated no significant differences in 90-day mortality between the ALPPS and other hepatic hypertrophy approaches. Furthermore, two high quality RCTs including 147 patients demon- strated no significant differences in major morbidity between the ALPPS and PVO cohorts.