Hepatic smooth muscle lipoma should refer to hepatic angiomyolipoma (HAML), a rare benign tumor of mesenchymal tissue origin in the liver. HAML tumors are benign tumors, which have a low incidence, most patients have no conscious clinical symptoms, lack of specificity in imaging, low preoperative diagnosis rate, and a portion of patients are easily misdiagnosed as hepatocellular carcinoma or other benign tumors of the liver. The final diagnosis relies on pathology and immunohistochemical staining. Surgery is the most effective means to treat this disease, and the surgical methods can be chosen from hepatic resection and local ablation according to the location and size of the tumor. Surgical resection is a safe and effective treatment option with a favorable prognosis. Although HAML is benign in nature, there is a possibility of malignant transformation, and very few HAML will undergo malignant transformation. Therefore, effective and rational surgical treatment should be carried out early after diagnosis.