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Background: The presence of clinically significant portal hypertension (CSPH) remains a relative contraindication to liver resection for patients with resectable hepatocellular carcinoma (HCC). The goal of this study was to explore whether a laparoscopic approach could extend the indications for hepatectomy to patients with PH. Method: Patients who underwent laparoscopic liver resection (LLR) from February 2016 to September 2019 performed by a single medical team were included in this study. We analyzed the surgical and oncological outcomes between groups with and without CSPH before and after propensity score matching (PSM). Result: We enrolled 156 patients divided into two groups according to the presence (CSPH, n= 26) or absence (non-CSPH, n= 130) of CSPH. CSPH group was associated with more clinical signs of liver dysfunction (p< 0.05). After PSM (n= 48 patients), the CSPH group tended to have a longer postoperative hospital stay (p= 0.054); however, there was no difference in operation time (p= 0.329), blood loss volume (p= 0.392), transfusion rates (p= 0.701), rate of conversion to open surgery (p= 0.666), surgical margin (p = 0.306), surgical mortality (n= 0), or comprehensive complication index (p= 0.844) between the two groups. The median follow-up time for the entire cohort was 19.6 months (range 0.2–40.6 months). The 3-year overall survival rate was 62.9% in the CSPH group and 84.3% in the non-CSPH group (p= 0.1090), and results were similar after PSM (p= 0.5734). Conclusions: LLR is safe and feasible for HCC with PH. The introduction of minimally invasive surgery, represented by LLR, can appropriately expand the indications for hepatectomy.