Abstract: Objective To evaluate the treatment outcome and identify prognostic factors for patients with retroperitoneal pleomorphic liposarcoma. Methods Clinical data about 47 patients with retroperitoneal pleomorphic liposarcoma managed with surgery from June 2007 to December 2013 in our hospital were retrospectively analyzed and all patients were followed up. Results Of the 47 cases, 17 patients received surgical resection for the first time, 30 patients were recurrent, 35 patients received radical resection, 12 cases received partial resection. The overall 1-, 3-, 5-year survival were 86.9%, 52.5% and 32.0% and the median survival time was 20 (2-64) months. Log Rank test showed that radical surgery (χ²=43.038, P< 0.01) and tumor necrosis (χ²=7.280, P=0.007) were associated with postoperative survival time. The difference between gender, age, removal of the joint organs, tumor size, primary or recurrent showed no statistical significance. Multivariate analysis showed that radical surgery (RR=61.630, P< 0.01) and tumor necrosis (RR=0.216, P=0.019) were prognostic indicators for retroperitoneal pleomorphic liposarcoma. Conclusion Retroperitoneal pleomorphic liposarcoma is the rarest type. It belongs to the high grade of tumor, and its prognosis is poor. Complete resection remains the mainstream treatment for retroperitoneal pleomorphic liposarcoma. In order to reach the goal of radical resection, resections of other adjacent organs are often needed. Radical resection and no tumor necrosis predict better postoperative survival period.