Liver surgery is often associated with increased likelihood of massive bleeding. The blood loss is one of major intraoperative issue the surgical team must deal with. Bleeding is usually present in cirrhotic patients but can be faced even in the patients with normal liver function undergoing liver surgery. Correction of preoperative abnormal coagulation's tests, strong interaction between the surgeon and the anesthesiologist, and finally the anesthesia technique, may successfully reduce the bleeding intensity and blood transfusions requirements. This review will be focused only in the anesthesiologist's role in minimizing the blood loss during major liver surgery.