We evaluated the efficacy of local ablation therapy in 40 patients with liver metastases from colorectal cancer. Radiofrequency ablation (RFA) and/or microwave coagulation therapy (MCT) were used. Ablation therapies were performed in percutaneous, endoscopic, and operative procedures. The regional recurrence rate at the therapeutic sites was 15% (median follow-up period of 2.5 years). The average surgical margin in the operative ablation group was 11 mm. The cumulative 5-year survival rates were 37% in the local ablation, 41% in the hepatic resection, and 5% in the regional chemotherapy groups. Major complications occurred in only two patients (one biliary fistula and one liver abscess). Together these observations indicate that local ablation therapy is a radical and safe locoregional therapy that provides adequate local control and contributes to long survival.