Although liver metastases from colorectal cancer previously conferred a very dismal prognosis, advances in systemic therapy combined with surgical techniques now gives these patients a reasonable chance for cure. Traditional cytoxic chemotherapy combined with biologic agents result in impressive response rates, allowing a portion of patients who were considered unresectable to undergo hepatectomy with curative intent. This review discusses the role of systemic therapy in patients with liver-limited metastatic disease for patients with resectable, potentially resectable and unresectable disease.