Objective：To determine the prognostic relevance of postoperative morbidity in advanced perihilar cholangiocarcinoma（PHC）. Methods：From 2008 to 2017，clinical data of patients undergoing major hepatectomy with caudate lobectomy for PHC were reviewed retrospectively. Severe morbidity was defined as any complication of Clavien-Dindo grade Ⅲ or Ⅳ. Results：A total of 123 patients were enrolled and severe morbidity occurred in 35 patients（28.4%）. The 5-year disease-specific survival and recurrence-free survival for those with and without severe morbidity were：12.9% versus 40.2%（P=0.012）and 0% versus 28.1%（P < 0.001），respectively. Multivariate analysis revealed that severe morbidity independently predicted decreased recurrence-free survival（hazard ratio=1.87，P=0.043）；however，severe morbidity did not emerge as an independent predictor of disease-specific survival. Subgroup analysis of patients stratified by morbidity grade showed similar results，while patients with minor morbidity showed similar survival to those without morbidity. Conclusion：Severe morbidity adversely affects survival outcomes following major liver resection for PHC；thus，optimal preoperative preparation and careful dissection are important to reduce postoperative complications and improve long-term survival.