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This recipient with situs inversus totalis (SIT) was a 60-year-old female who had hepatitis B-related endstage liver disease. Preoperative donor evaluation showed that the right posterior section satisfied graft volume and was space-fitting in the recipient hepatic fossa when it was rotated 180 degrees. The operation and postoperative course progressed satisfactorily. Three weeks after living donor liver transplantation (LDLT), the graft function was disturbed by compression of bottom-placed right hepatic vein. This was treated with a vascular stent and subsequently the graft function was normalized. The present case shows that LDLT for patients with SIT using a right posterior section graft is feasible.