Abstract： Objective To evaluate the clinical effect of ABO-incompatible liver transplantation. Methods From Jan. 2004 to Jan. 2008, 16 cases of ABO-incompatible liver transplantation were studied in 2188 liver transplantations. The blood agglutinin titer was monitored and the patients were treated with quadruple immunosuppression therapy perioperatively. Survival rate, liver function recovery, acute rejection, vascular and biliary tract complication were monitored. Results The mortality in perioperative period was 25% (4/16). The 6-month survival rate was 75 % (12/16) and 1-year survival rate was 37. 5 % (6/16). Postoperative complications included acute rejection in 3 cases, infection in 5 cases, multiple organ failure in 1 ease and biliary tract complication in 1 ease, respectively. Conclusions The prognosis of patients receiving ABO incompatible liver graft is poor, hence it is often applicable in the setting of emergency. Comprehensive treatments before and after operation contribute to the reduction of rejection occurrence and increase of the survival rate.