Abstract: Objective：To investigate the value of indocyanine green (ICG) test combined with Child-Pugh classification in evaluating perioperative liver function reserve in elderly patients with hepatocellular carcinoma (HCC). Methods：A total of 104 elderly patients with HCC treated in our hospital from January 2008 to December 2012 were selected. The liver function was evaluated by Child-Pugh classification or Child-Pugh classification combined with ICG R15 in these patients before operation, and the liver function after operation and the value of combination assessment were analyzed. Results：There was positive correlation between ICG R15 score Child-Pugh (r=0.81, P<0.0001). Patients evaluated by Child-Pugh classification combined with ICG R15 had a better post-operation recovery than those evaluated by Child-Pugh classification alone. Conclusions：Child-Pugh classification combined with ICG R15 might be superior to Child-Pugh classification alone in evaluating perioperative liver function reserve in elderly patients with HCC.