Hepatic hemangioma is a relatively common benign lesion of the liver, soft in texture, mostly clearly demarcated from adjacent tissues, and presenting as a dark red or blue-purple cystic elevation, which may be lobulated or nodular in shape. The cause of its formation is unknown and is thought to originate from embryonic vascular misshapen buds in the liver, while some believe it is related to estrogen levels, as it is six times more common in women than men. The disease can occur at any age and is usually solitary, located in the right lobe of the liver, with multiple occurrences in about 10%, and can be distributed unilaterally or bilaterally in the liver lobe. The disease develops slowly and can last from several years to decades. When the tumor is small, it is asymptomatic and is often detected during physical examinations for imaging or other procedures. Smaller hemangiomas are mostly asymptomatic, but when they increase in size, they may be accompanied by symptoms of pressure, such as abdominal discomfort and postprandial fullness. In addition, there may be fibrous tissue and mechanized thrombus inside the tumor, which may cause swelling of the tumor and distension of the liver peritoneum due to repeated thrombosis. Rarely, tumor rupture may cause hemorrhagic shock and acute abdominal symptoms. A few hemangiomas may form arteriovenous fistulas in the liver, which may increase the amount of blood returned to the heart and cause congestive heart failure. When the tumor is large, a mass can be palpated in the upper abdomen with a smooth surface, medium or soft texture, and may be lobulated, with cystic sensation and varying degrees of compression, usually without pressure pain, or with only mild pressure pain. Patients with hepatic cavernous hemangioma show mostly normal blood tests for liver function, AFP, hepatitis-related antigens and antibodies. Imaging examination is more helpful for clinical diagnosis. Ultrasound lesions can be divided into three types: strong echogenic type: this type is more common, and is a round or oval sharply edged or well-defined strong echogenic cluster, which is characterized by the reflection of numerous blood-vessel wall interfaces within the tumor. The internal echogenicity is divided into two types: uniform and inhomogeneous. Small, network-like hypoechoic areas can be seen within the inhomogeneous clusters, with slightly enhanced echogenicity at the edges. Mixed type: The edges of this type are not clear or blurred, and the internal echogenicity is unevenly distributed, with strong echogenicity and irregular echogenic areas. Cystic type: The edges are clear, with a strong echogenic band, and the interior is irregularly echogenic. On CT scan, single or multiple round or round-like hypointense foci with clear borders can be seen in the liver, with a few small calcified density shadows and irregular hypointense shadows within the tumor. The different performance of CT is related to the histological type of the tumor, thin-walled type has large lumen, more contrast entry, longer residence time and gradual dispersion, delayed scan can eventually be isointense. The thick-walled type has more interstitial tissues and small luminal spaces, so the contrast agent does not easily enter or rarely enters, showing no enhancement or no enhancement at all; the mixed type shows a mixed lesion with partial enhancement and no significant enhancement. In the T1-weighted image of MRI, the lesion is round or ovoid with clear, smooth, uniform low-signal areas or isosignal, and in the T2-weighted image, it is a uniform high-signal area, and its signal increases with the prolongation of echo time, forming a typical “light bulb sign” against the black liver signal. On Gd-DTPA dynamic enhancement scan, the lesion showed significant persistent enhancement, and the larger lesion showed centripetal enhancement. Parenchymal enhancement and subsequent hyperinflation are characteristic of hepatic hemangiomas. The mean value on T2-weighted image of hepatic hemangioma is higher than that of hepatocellular carcinoma, liver metastases and liver tissue can be used as a differentiator. Nuclear liver scan: In static scans, intrahepatic occupying lesions appear as radiolucent or radiolucent areas; in dynamic imaging, the arterial and venous phases may or may not be visualized, but the radiolucent intensity of the hepatic blood pool in the equilibrium phase is higher than that of normal liver tissue and appears as a limited, well-defined overfilled area. The phenomenon of “slow perfusion” is one of the characteristics of hepatic hemangioma. However, in recent years, the application of ultrasound, CT and MRI has increased and the sensitivity and specificity of diagnosis has improved, and the application has gradually decreased. Hepatic angiography is also important for the diagnosis of hemangioma, but its clinical application is gradually decreasing due to its invasive nature. Hepatic cavernous hemangioma is considered as benign tumor of the liver, therefore, tumor diameter <5cm and asymptomatic tumor do not need surgical treatment, regular review and follow-up; if there are obvious symptoms, tumor is close to major blood vessels or liver cancer cannot be excluded, then surgical resection can be considered. If the tumor is 5-10cm in diameter, elective surgical resection is recommended; if the tumor is located at the liver edge, there is a possibility of traumatic rupture and hemorrhage, early surgical resection is recommended; if the tumor is >10cm in diameter, surgical resection, or liver transplantation is generally recommended. For patients with multiple hemangiomas, resection one by one, or resection combined with bundling can be considered. Surgical resection includes traditional open surgery, some of which require combined open-heart surgery. At present, our department has widely carried out minimally invasive laparoscopic surgery to remove hepatic hemangiomas, which greatly promotes the recovery of patients after surgery. If patients cannot tolerate surgery in general, interventional embolization can be considered, but interventional embolization often cannot control the growth of hemangioma. Some scholars have started to use radiofrequency and gamma knife for the treatment of hepatic hemangiomas, but the effect is poor for larger hemangiomas and the long-term effect is unclear.