Over the past six decades, liver transplantation has witnessed continuous advancements in its technical system and clinical concepts, and has now become standardized treatment for end-stage liver disease. Notably, large-for-size liver syndrome (LFSS) caused by graft-recipient size mismatch remains one of the major challenges restricting the efficacy of adult liver transplantation. Accurate preoperative assessment, rational surgical planning, and targeted intraoperative intervention are key links in preventing and controlling this complication. With the in-depth study of its pathological mechanism, targeted intervention strategies such as delayed abdominal closure, graft volume reduction, and portal blood flow regulation have been constantly improved. The application of innovative technologies including augmented reality, virtual reality, three-dimensional printing, and artificial intelligence further provides multi-modal visual support for preoperative assessment and planning. This article systematically reviews the research progress on the core mechanism of LFSS and summarizes the innovative application of various new technologies in liver transplantation surgery, aiming to provide theoretical support and technical route reference for improving the clinical prognosis of liver transplantation.