Hepatic hemangioma is the most common benign tumor of the liver. With the popularization of ultrasonography, the diagnosis rate of hepatic hemangioma is increasing. The incidence of hepatic hemangioma is significantly higher in women than in men, and most of them are solitary, with multiple cases accounting for about 20%. Hepatic hemangioma has become one of the most common reasons for visits to hepatobiliary surgery clinics. Hepatic hemangiomas are mainly caused by the proliferation of vascular components in the liver and contain a large number of blood sinuses with a slow flow of blood through them. Most hepatic hemangiomas grow slowly, even without significant growth for several years; however, some hemangiomas are relatively fast and can grow exponentially in size within a few years. When the hepatic hemangioma is small, it has no obvious symptoms and has no effect on liver function. As the size of hemangioma gradually increases, the tumor may compress the surrounding tissues or cause infarction within the tumor, resulting in symptoms such as distension and pain in the upper abdomen. The larger the tumor and the more numerous it is, the more likely it is to produce symptoms. Only when there are multiple tumors in the left and right liver and the size of the tumor is huge, will it cause significant damage to liver function. Hepatic hemangiomas are usually not malignant, but there is a possibility of spontaneous rupture and bleeding as the tumor increases in size. To avoid this, the timing of treatment is very important. When do I need treatment for hepatic hemangioma? Because the growth rate of hepatic hemangiomas is not yet measurable, there is controversy as to whether or not the disease requires surgical treatment. In our experience, it is generally accepted that larger hepatic hemangiomas less than 5 cm in size, which do not cause clinical symptoms or are not severe, can be followed up regularly without surgical removal. Treatment is required if: 1) the nature of the hepatic hemangioma is difficult to distinguish from other hepatic occupying lesions, especially if combined with positive hepatitis virus indicators or a history of chronic liver disease; 2) hepatic hemangiomas with clinical manifestations, such as abdominal pain, adjacent organ compression, kasabach-Merritt (abnormal platelet consumption) syndrome; 3) hemangiomas with significant growth rate; 4) hemangiomas >10 cm; 5) hemangiomas in young women 5.Large hepatic hemangioma in young women: hepatic hemangioma has the characteristics of accelerated growth during pregnancy and the risk of rupture and hemorrhage during childbirth; 6.Special occupations: for those who are engaged in strenuous sports or enthusiasts, such as boxing, soccer, etc., huge hepatic hemangioma that may cause liver trauma can be considered for surgical resection; which patients with hepatic hemangioma need treatment? In outpatient clinics, we often encounter patients who anxiously ask: “Doctor, I have a hemangioma on my liver, does it matter and do I need an operation?” In fact, when we talk about hemangioma of the liver, we mainly refer to cavernous hemangioma, which is not a real tumor, but a kind of misshapen “tumor”, a developmental abnormality that usually stops growing in adulthood and usually does not need treatment. In some special cases, treatment should be considered: 1) when the hemangioma is large (usually >5 cm), causing compression of the surrounding tissues or pain in the liver area (it can be symptomatic when it is against the liver edge); 2) when the hemangioma grows slowly and continuously; 3) when the hemangioma suddenly increases in size and malignancy is suspected (rare). Most hepatic hemangiomas are less than 5 cm in diameter and grow slowly, no special treatment is needed, and regular follow up for 6 months or a year is sufficient. When the growth trend of hemangioma is obvious, or the tumor increases to the point of producing clinical symptoms such as abdominal distension and gastric distension, active treatment is required. If a patient’s hepatic hemangioma has grown from 3 cm to 6 cm in the last 3 years, it is advisable to actively treat such a hepatic hemangioma to avoid growing larger and larger and delaying the best time for treatment. For hepatic hemangioma that is already 6 cm when found but no obvious growth trend is observed in the last 3 years, although its lesion is large, it should not be treated actively if there are no obvious symptoms. How to choose the treatment for hepatic hemangioma? Hepatic hemangioma is still not found to have curative drugs for liver blood vessels, so patients with hemangioma <5cm do not need to seek medical help everywhere and regular follow-up is sufficient. 1.Tumor diameter <5cm, no need for surgery, regular review and follow-up. 2.For tumor diameter of 5-10cm, surgery can be considered. 3.For tumor diameter >10cm, surgery is usually performed.