Objective To investigate the relation between artery location for anastomosis and recipient’s hepatic arterial anatomic variation or pathological abnormity in adult liver transplantation. Methods From March 2004 to July 2006, 80 cases of adult orthotopic liver transplantation (OLT) were performed in this hospital. Preoperative magnetic resonance angiography combined with operative artery dissection were performed to recognize and classify the hepatic arterial variation or pathological abnormity, then the arterial anastomotic location and stoma diameter were recorded. The location and diameter of anastomosis were compared between variation group and non-variation group. Results The recipient’s hepatic arterial variation rate was 11.3%(9/80), 8/9 of variable artery were right hepatic arteries which arose from gastroduodenal artery (GDA), common hepatic artery (CHA), celiac artery or superior mesenteric artery. The locations for anastomosis were the branch patches of CHA (7/9) and GDA (2/9). The pathological abnormities comprised of hepatic arterial intimal dissection (1 case) and hepatic arterial stenosis (1 case), the corresponding anastomotic location was the end of CHA in former case and anterior wall of suprarenal aorta in latter case. The proportion of anastomotic locations differed statistically between variation group and non-variation group (χ2=18.679, P＜0.01). The anastomotic diameter of CHA branch patch in variation group had no statistic difference compared with branch patch of CHA or proper hepatic artery (PHA) in non-variation group (Pgt;0.05). Conclusion The recipient’s hepatic arterial variation influences the selection of locations for anastomosis, the branch patch of CHA is the preferred location. The anastomotic stoma diameter of PHA branch patch in non-variation group obtains a similar size of CHA branch patch in variation group, the PHA branch patch can be used as a common location when arterial variations are absent.