OBJECTIVES: Clinical research has demonstrated that laparoscopic liver resection for hepatocellular carcinoma or secondary colorectal metastases provides oncologically equivalent patient outcomes when compared to open liver resection, while also providing a statistically significant reduction in postoperative complications. Approximately 16% of all liver resections in Canada are performed laprascopically with a compound annual growth rate of 16%. In the Canadian healthcare environment hospitals face constrained budgets and it is critical to demonstrate the impact of laparoscopic liver resection to increase procedure volume. This study was conducted to determine the budget impact of increasing the proportion of laparoscopic vs. open liver resection in a Canadian hospital. METHODS: We examined the budget impact of increasing the percentage of laparoscopic liver cases from 16% to 40%, while decreasing the number of open cases proportionately in a hospital that performs 50 resections annually. The model incorporates the costs associated with surgery, length of stay (taking into account facility and staff costs) and postoperative complications. The cost data used in the model was obtained from peer reviewed literature, the Ontario Case Costing Initiative and costing data from a large Canadian hospital.  Data on patient outcomes was obtained from published meta-analyses. A multivariate sensitivity analysis using a Monte Carlo simulation was completed to ensure scientific rigour. RESULTS: Laparoscopic liver resections are associated with higher device costs, but similar overall procedure costs. The additional device cost is offset by a shorter length of stay and lower rate of post-operative complications. The model establishes that for a Canadian hospital performing 50 liver resections increasing the proportion of laparoscopic cases from 16% to 40% allows for a potential cost savings of CAD $50,730 annually. CONCLUSIONS: In a Canadian hospital, laparoscopic liver resection is a more cost-effective procedure for hepatocellular carcinoma or secondary colorectal metastases when compared to open resection.