The risk of venous thrombosis is well documented in patients with malignancies, those undergoing abdominal surgery, and those undergoing hepatic resection for malignancy. This study was undertaken to determine whether there was a difference in the risk of thrombosis between those undergoing resection for hepatic metastases and primary hepatic malignancies. We performed a retrospective chart review of patients undergoing initial surgical resection for hepatic malignancies, primarily to determine whether there was a difference in the incidence of venous thrombosis between those with primary and secondary malignancies. Ninety-nine patients underwent surgical resection for either primary or secondary hepatic malignancies from 2001 to 2006. Seven of these patients, all with secondary hepatic malignancy, developed venous thrombosis within 3 months of resection. This retrospective review reveals that a clinical presentation of venous thrombosis is significantly more common among patients undergoing hepatic resection for secondary malignancy than those undergoing resection for primary cancer of the liver. Special attention with regard to prophylaxis for thrombosis may be required in these patients.