Objective To evaluate the effect of postoperative transcatheter arterial chemoembolization (pTACE) on the long-term prognosis of patients with intrahepatic cholangiocarcinoma (ICC), and to identify the proper ICC patients for the adjuvant therapy. Methods A total of 114 ICC patients were included, who received radical resection at the Eastern Hepatobiliary Surgery Hospital of Second Military Medical University from Jan. 2010 to Dec. 2011. Univariate and multivariate analyses were performed to determine the independent risk factors of overall survival (OS) and recurrence-free survival (RFS). Patients with one or more risk factors for relapse were included in the high-risk group (n=73) and those without risk factors of relapse were included in the low-risk group (n=41). The effect of pTACE on the prognosis of patients in the two groups was compared. Results Multivariate analysis results showed that multiple tumor (HR=3.515, 95%CI 2.083-5.932, P<0.001), tumor maximum diameter >5 cm (HR=2.050, 95%CI 1.309-3.210, P=0.002), microvascular invasion (HR=2.287, 95%CI 1.104-4.736, P=0.026), positive surgical margin (HR=5.089, 95%CI 2.055-12.600, P<0.001) and lymph node metastasis (HR=2.880, 95%CI 1.579-5.251, P=0.001) were the independent risk factors of OS; and multiple tumor (HR=2.752, 95%CI 1.619-4.678, P<0.001), tumor maximum diameter >5 cm (HR=2.010, 95%CI:1.298-3.113, P=0.002) and microvascular invasion (HR=3.857, 95%CI:1.856-8.013, P<0.001) were the independent risk factors of RFS. pTACE was not an independent prognostic factor of OS or RFS, but pTACE significantly improved OS and RFS of patients in the high-risk group compared with the low-risk group (P< 0.05). Conclusion ICC patients with independent risk factors of relapse after surgery can benefit from pTACE, suggesting that they should receive pTACE therapy.