Hepatic coma is also known as hepatic encephalopathy. It is a central nervous system syndrome caused by severe hepatic insufficiency and is based on metabolic disorders. The most fundamental direct cause of hepatic encephalopathy is hepatic coma due to diffuse damage of liver parenchyma caused by liver cirrhosis, severe hepatitis or liver cancer. The main clinical manifestations are disorders of consciousness, behavioral disorders and even coma, and there is often a distinction between acute and chronic encephalopathy. Treatment should actively eliminate the causative factors to avoid or block the occurrence and further development of hepatic encephalopathy caused by the increase of blood ammonia is the most basic treatment strategy and the key to treatment. Pay attention to actively preventing and controlling gastrointestinal bleeding, controlling infection, correcting water-electrolyte and acid-base balance disorders, prohibiting liver-damaging drugs, avoiding the release of large amounts of ascites for a short period of time, etc.; minimize the production of ammonia and promote oxygen metabolism. For hepatic encephalopathy that has occurred, on the basis of removing the causative factors, the first choice of drug therapy is to try to restore brain cell function. If the patient does not respond to all drugs and there is no contraindication to surgery, treatment such as portal shunt embolization or liver transplantation can be chosen according to the patient’s condition and hospital conditions. In conclusion, hepatic coma is a clinical symptom of severe liver cell damage and metabolic disorders of the liver. If left untreated, the mortality rate is very high.