Purpose <p>To assess the technical feasibility and outcome of cryoablation with simultaneous bile duct protection in patients with centrally located liver tumors (CLLT).</p> Material and Methods <p>Three patients (all male, 40–79&#xa0;years) with CLLT located in close proximity to the right (<i>n</i> = 2) or left (<i>n</i> = 1) hepatic duct were included in this retrospective study. Prior to cryoablation, a nasobiliary tube was placed endoscopically in the respective bile duct. In two cases, additional temporary bile duct stent placement was performed. CT-guided cryoablation was realized with simultaneous bile duct perfusion using warm saline. Technical success, effectivity and complications were assessed.</p> Results <p>Three CLLT (hepatocellular carcinoma (HCC) <i>n</i> = 2; metastasis <i>n</i> = 1; tumor size 9–15&#xa0;mm) were treated. Cryoablation was technically successful in all cases and treatment effectivity (A0 ablation) was 100%. Nasobiliary tubes were removed immediately after the ablation procedure, bile duct stents were removed –six to eight weeks after ablation. At the latest available follow-up for each patient (909, 343 and 32&#xa0;days), no bile duct-related complications were observed. No local tumor recurrence was observed in the two patients who survived longer than three months.</p> Conclusion <p>According to our initial experience, percutaneous cryoablation of CLLT with simultaneous bile duct protection is technically feasible without an increased risk of biliary complications and local tumor recurrence.</p> Graphical Abstract <p></p>