Colorectal cancer metastatic to the liver is a common oncologic problem, and carefully selected patients can be successfully treated with surgical resection of liver metastases. Perioperative chemotherapy has been shown to increase progression-free survival in patients with resectable liver metastases and can currently be considered a standard therapy for eligible patients. Preoperative chemotherapy can downstage unresectable liver metastases and allow a complete resection. More aggressive chemotherapy as well has the incorporation of targeted agents such as cetuximab and bevacizumab into modern chemotherapy regimens has resulted in higher response rates, which may translate into improved survival. Preoperative chemotherapy can increase postoperative complications after hepatic resection, and the decision to use such therapy should be made in a multidisciplinary setting.