ObjectiveTo investigate the clinical efficacy of the free, open-source 3D Slicer software and the commercial Hisense 3D visualization technique platform operated by a professional team in the treatment of hepatic alveolar echinococcosis (HAE). MethodsA retrospective analysis was performed on the clinical data of patients with HAE admitted to People’s Hospital of Aba Tibetan and Qiang Autonomous Prefecture from August 2021 to August 2025. The patients were divided into the 3D Slicer group and the Hisense group according to the 3DVT method. Based on the 3D visualization technique results, surgeons conducted accurate preoperative evaluation, formulated surgical plans, and performed precise hepatectomy. The intraoperative and postoperative conditions of the two groups were compared. ResultsA total of 65 patients were ultimately enrolled, with 31 in the 3D Slicer group and 34 in the Hisense group. There were no statistically significant differences in baseline characteristics between the two groups (P>0.05). All surgeries were successful without perioperative mortality. No statistically significant differences were observed between the two groups in operation time, intraoperative blood loss, total hepatic occlusion time, liver function on postoperative days 1 and 3, incidence of postoperative complications, total hospital stay, total hospitalization costs, 3D simulated and actual liver resection volumes, 3D simulated and actual volumes of HAE lesions, or the error between 3D simulated and actual volumes of HAE lesions (P>0.05). However, compared to the Hisense group, the 3D Slicer group exhibited a smaller error between 3D simulated and actual liver resection volumes [(28.84±13.75) mL vs. (57.74±20.09) mL, P<0.001], but the time for surgeons to perform 3DVT was longer [(274.84±24.61) mL vs. (29.56±10.10) mL, P<0.001]. Conclusions In HAE hepatectomy, the clinical outcomes with 3D Slicer-assisted surgery are comparable to those using the commercial Hisense 3D visualization technique platform. Both methods demonstrate comparable surgical safety, precision, and short-term outcomes. Although 3D Slicer may offer higher accuracy in simulated liver resection, it entails a significantly longer operation time.