AIM: To evaluate the prognostic value of imaging patterns in combined hepatocellularcholangiocarcinoma. MATERIALS AND METHODS: A total of 36 patients with histopathologically confirmed combined hepatocellular-cholangiocarcinoma were enrolled. Pretreatment imaging was conducted to evaluate the tumour enhancement patterns, based on which the diseasewas classified as two subtypes: radiographic hepatocellular carcinoma-dominant (n=26) and radiographic cholangiocarcinoma- dominant (n=10). Moreover, based on the proportion of components, all combined hepatocellular- cholangiocarcinoma cases were divided into histopathological hepatocellular carcinoma- dominant (n=26) or histopathological cholangiocarcinoma- dominant (n=10). The KaplaneMeier method was used to compare patient outcome between the two subtypes of each classification. Univariate Cox regression analysiswere employed to evaluate the prognostic relevance of the imaging and histopathological classification. RESULTS: Consistency between histopathological and imaging classification was not high. Only 66.7% of patients had consistent classification. Moreover, the median overall survival of the radiographic cholangiocarcinoma-dominant and radiographic hepatocellular carcinomadominant population was 15.03 and 40.4 months, respectively (p=0.012); however, no significant difference was observed between histopathological type, with median overall survival being 32.07 and 40.4 months in the histopathological cholangiocarcinoma-dominant group and histopathological hepatocellular carcinoma-dominant group, respectively (p=0.784).