Liver resection remains the only curative treatment for hepatocellular carcinoma, colorectal liver metastases, and cholangiocarcinoma. However, extended hepatectomy poses a risk of postoperative hepatic failure due to an insufficient future liver remnant (FLR). Preoperative portal vein embolization (PVE) has been widely adopted to induce FLR hypertrophy, thereby improving surgical feasibility. This chapter reviews the current evidence regarding PVE, including its indications, efficacy, safety, and evolving strategies. The decision to perform PVE requires a precise assessment of FLR volume and function. Recent advancements in 3D simulation and liver function tests, such as ICG-R15 and hepatobiliary scintigraphy, have improved FLR evaluation. The minimal FLR/(standardized) total liver volume (TLV) thresholds for safety vary based on the background liver condition. Generally, a threshold of 25%–30% is considered safe for patients with a normal liver, while those with an injured or cirrhotic liver require additional 10% or more FLR for safe surgery. PVE efficacy is assessed within 2–4 weeks post-procedure, with a median degree of hypertrophy (i.e., the percentage point difference between the liver volume before and after PVE) of approximately 10%. The kinetic growth rate and emerging imaging modalities further refine patient selection. PVE can be performed primarily via percutaneous transhepatic approach, with embolic materials, including polyvinyl alcohol, N-butyl cyanoacrylate, and absolute alcohol, each offering distinct advantages. Extended PVE (segment 4 embolization) and its combination with two-stage hepatectomy, ALPPS, and hepatic vein deprivation are expanding resectability in complex cases. While PVE remains the standard for FLR augmentation, ongoing innovations continue to enhance its safety and efficacy. This chapter provides a comprehensive guide to optimizing PVE strategies for hepatobiliary surgeons and interventional radiologists worldwide.