Hepatic hemangioma is a relatively common benign tumor of the liver, with cavernous hemangioma being the most common clinically. In recent years, with increased awareness of health screening and advances in various diagnostic imaging techniques, the detection rate of asymptomatic small hemangiomas has increased significantly. Most cases are clinically asymptomatic, with a long, slow-growing course, mild symptoms, and a good prognosis. At present, there are not many basic and clinical studies on this disease, and there is a lack of mature and strict diagnostic and treatment standards, and there are many ambiguities and even misconceptions about the definition of treatment options and indications. There is no unified clinical pathway for doctors and patients to choose. Currently, there are controversial treatment methods for hepatic hemangioma, including hemangioma resection, hemangioma suture, hepatic artery ligation, microwave curing, radiofrequency treatment, and hepatic artery embolization. For diffuse hepatic hemangioma, or huge hemangioma that cannot be removed, and for hepatic hemangioma that requires treatment, a variety of factors should be considered, and different treatment methods should be selected based on the principle of patient benefit, safety and effectiveness, and weighing between multiple factors based on the technical level and experience of the doctor. Surgical resection of hepatic hemangioma is reliable and safe, and complete resection is the only method that can cure it. With the development of surgical techniques, the incidence of surgery-related complications and mortality rates are now very low. Nevertheless, the indications for surgery still need to be strictly controlled. Common surgical methods include hepatic segmental resection, hemangioma debulking, laparoscopic hepatectomy, hemangioma suturing, liver transplantation, etc. 1.Hepatic segmental resection With the development of surgical techniques and improvement of liver surgery skills, the mortality and complications of hepatectomy have been greatly reduced, and the application has been expanded to benign lesions of the liver, among which hepatic hemangioma is the benign lesion of the liver most often used for hepatectomy. Most patients with hepatic hemangioma do not have a history of cirrhosis, have good hepatic compensatory function, and can tolerate a wide range of hepatic resections. For huge hepatic hemangioma or multiple hemangiomas, regular hepatic segmental resection, lobectomy or even hemihepatectomy is usually feasible, but the amount of hepatic resection should not exceed 70%-75% of the whole liver. The main problem of hepatic segmental resection for hepatic hemangioma is to control bleeding, because the blood supply of hemangioma is rich and the tumor itself is easy to bleed, which makes the operation more difficult, and even sometimes improper operation can lead to uncontrollable hemorrhage. 2.Hepatic hemangioma debridement Hepatic hemangioma is mostly swelling growth, which can compress the normal liver tissue, bile duct and blood vessels to form a thin fiber envelope, and there are few blood vessels in this interface. This procedure was first reported by Alper et al. in 1988, and several large clinical studies comparing hepatectomy and hemangioma debridement found that the operative time, bleeding and blood transfusion of debridement were significantly less than those of hepatectomy. The incidence of biliary fistula is reduced. It has become the main procedure for the treatment of hepatic hemangioma, and is now advocated by many scholars at home and abroad. The rule of thumb hepatectomy is only used when malignancy is suspected or when a lobe of the liver is completely occupied by a tumor. However, some scholars believe that in some cases, it is difficult to confirm the gap between the hemangioma and liver parenchyma intraoperatively, and peeling may cause more bleeding, especially for hemangiomas close to the hepatic vein trunk, posterior inferior vena cava and other important structures. Laparoscopic liver resection technology has become increasingly mature, and its minimally invasive advantages such as less trauma, fewer complications and faster recovery are very obvious, and its application rate is increasing year by year. Its postoperative complications are similar to those of open surgery, and the postoperative recovery is fast and the hospital stay is short. Laparoscopic left outer lobe and left hemihepatectomy is expected to become the standard procedure for the treatment of hepatic hemangioma. However, hepatic hemangiomas in the right posterior lobe, middle liver lobe and caudate lobe are difficult to perform total laparoscopic hepatectomy because of their special location and susceptibility to hemorrhage. Although the application of laparoscopic hepatectomy for hepatic hemangioma is limited at present, with the development and breakthrough of laparoscopic technology, laparoscopic hepatectomy for hepatic hemangioma will have a broad application prospect. 3.Liver transplantation Hepatic hemangioma is a benign lesion, and liver transplantation is only used for unresectable giant hepatic hemangioma and serious complications such as Kasabach-Merritt syndrome, which has not been widely carried out yet. 4. Ligation Hepatic hemangioma suture ligation Hepatic hemangioma suture ligation is used to treat hemangioma by suturing the hemangioma to make the tumor shrink, mechanize, or even disappear. Due to the lack of understanding of liver anatomy in the past, the smaller the tumor body is, the longer the embrace of ligation time, the better the effect, while the larger the tumor body is, the shorter the ligation time, the worse the effect. In recent years, with the deeper understanding of liver anatomy and the progress of medical technology, the recurrence rate of hemangioma ligation and the proportion of hemangioma increasing again after surgery have increased, and the use of gradually decreased. 5.Hepatic artery ligation Hepatic hemangioma is mainly supplied by hepatic artery, and ligation of hepatic artery can temporarily reduce the size of the tumor and make it soft. Combined with post-operative radiotherapy, it can harden the tumor and improve the symptoms and control the tumor growth. However, due to the presence of collateral circulation, the efficacy is mostly difficult to maintain and the long-term effect is limited. Hepatic artery ligation is mainly used for unresectable giant hemangiomas. Due to the adoption of new technologies in recent years, hemangiomas previously thought to be unresectable can now be safely removed in hepatobiliary surgery centers with superior technical conditions, so simple hepatic artery ligation is rarely used to treat hepatic hemangiomas. In conclusion, the diagnosis and treatment of hepatic hemangioma are progressing, and as a common and frequent disease of the liver, clinical attention should be paid to it, and treatment should be cautious and strict, and attention should be paid to differentiate it from other lesions of the liver, especially malignant diseases.