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Background: Combining hepatic arterial infusion (HAI) with systemic chemotherapy is a proved strategy to improve resection rate in initially unresectable colorectal cancer liver metastases (CRCLM).However, this combined strategy was rarely reported as initial treatment in synchronous CRCLM patients with primary tumor in situ.Methods: HAI catheter systems were implanted radiologically in 42 consecutive patients with unresectable synchronous liver-only metastases not selected for resection.HAI FUDR and systemic XELOX were delivered in the next day after catheter implantation.The clinical data of the patients were collected from a prospective database.