Objective To analyze the risk factors for complications after laparoscopic surgery for primary liver cancer patients with cirrhotic portal hypertension, so as to provide references for improving perioperative management. Methods The clinical data of 105 patients were retrospectively analyzed, and their surgical complications were recorded. The independent risk factors of complications were analyzed using univariate analysis and logistic regression analysis. Results The overall incidence of surgical complications was 68.57%,with the incidence of pulmonary infection, portal vein thrombosis and pleural effusion of 25.71%, 33.33% and 28.57%, respectively. The preoperative Child-Pugh grade, MELD score, hemoglobin concentration, postoperative bed-bound time and abdominal drainage tube indwelling time were risk factors for overall surgical complications (all P<0.05). Smoking, preoperative MELD score, preoperative ascites, surgical method, postoperative bed-bound time and gastric tube indwelling time were risk factors for pulmonary infection (all P<0.05). Moreover, the preoperative Child-Pugh grade, platelet level, preoperative ascites, and surgical method were risk factors for portal vein thrombosis (all P<0.05). Meanwhile, age and preoperative MELD score were risk factors for postoperative pleural effusion (both P<0.05). Conclusion Primary liver cancer patients with cirrhotic portal hypertension face high risks for their laparoscopic operation. Therefore, specialized nursing should be provided accordingly to reduce the incidence of surgical complications.