BackgroundEnhanced recovery programmes are associated with improved short-term outcomes following liver surgery. The impact of enhanced recovery programmes on medium- and long-term outcomes is incompletely understood. This study aimed to assess the impact of an enhanced recovery programme on long-term survival in patients undergoing surgery for colorectal liver metastases.MethodsAt a tertiary hepatobiliary centre, we analysed short-, medium- and long-term outcomes in consecutive patients undergoing liver resection for colorectal liver metastases. A five-year retrospective review was carried out comparing the enhanced recovery programme to standard care.ResultsA total of 172 patients were included in the analysis: 87 on standard care and 85 on an enhanced recovery programme. Open surgery was performed in 122 patients: 74 (85.1%) and 48 (56.5%) patients in the standard care and enhanced recovery programme, respectively (p< 0.001). There was a significant reduction in the median (IQR) length of hospital stay in the enhanced recovery programme compared with standard care (7 (5) days vs. 8 (3) days,p= 0.0009). There was no significant difference in survival between standard care and the Enhanced Recovery Programme at one (p= 0.818), three (p= 0.203), and five years (p= 0.247).ConclusionAn enhanced recovery programme was associated with a reduced length of hospital stay. There was no effect on the one-, three- and five-year survival.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00423-023-02968-4.