To observe changes of the tongue and research the pattern characteristics in perioperative patients with primary liver cancer（ PLC）. Methods Totally 103 PLC patients scheduled for surgery were collected. The tongue was observed from 6: 30am to 8: 00am one day before surgery and on the 1st

3rd and 5th day after surgery. The TCM Tongue questionnaire was filled. The tongue pictures were taken with digital camera. The average RGB（ red

green and blue） component values of tongue and tongue fur were analyzed with TCM Tongue Examination Comprehensive Information Processing System. Results The purple tongue was common before surgery and on the 3rd and 5th day after surgery and red tongue was common on the 1st day after surgery（ P < 0. 05）. The R value of tongue was increased after surgery especially on the 1st day after surgery but the R value of tongue was gradually decreased on the 3rd and 5th day after surgery（ P < 0. 05）. Comparing with one day before surgery

the R

G and B values of tongue fur were gradually decreased on the 3rd and 5th day after surgery（ P < 0. 05）. The enlarged tongue

tongue bearing dental impressions and prickly tongue was increased after surgery（ P < 0. 05）. The thick and slimy tongue fur was common before and after surgery

especially after surgery（ P < 0. 05）. Comparing with one day before surgery

the width of sublingual veins was significantly decreased on the 1st

3rd and 5th day after surgery（ P <0. 05）. Conclusion The tongues of blood stasis pattern

water-damp pattern and qi deficiency pattern are common during the perioperative period of PLC but the tongues of yin deficiency internal heat pattern are increased within 5 days after surgery.