Left hemi-colon has special bidirectional arterial blood supply, and its lymphatic drainage can drain to the superior mesenteric vessels and inferior mesenteric vessels at the same time. The blood supply of left hemi-colon depends on branch vessels of inferior mesenteric artery(IMA) and middle colic artery(MCA), and high vascular variation brings uncertainty about the dominant vessels and the direction of the main lymphatic drainage. Recently, in addition to the middle colic and left colic artery(LCA),the accessory middle colic artery (AMCA) has been recognized as a feeding artery for the left hemi-colon. Surgery for located in the left hemi-colon cancer is difficult to perform because of the complex anatomy of high vascular variation. In the radical resection of left colon cancer, adequate mobilization of the colon is particularly important to meet the sufficient resection margin and the root ligation of both sides of the blood supply vessels. The anatomical understanding of left hemi-colon vessels provides a theoretical basis for vascular management and lymph node dissection in radical resection of left hemi-colon cancer.