With the popularization of health checkups and the progress of imaging technology, the detection rate of hepatic hemangioma is getting higher and higher. In clinical work, it is found that there are certain misunderstandings about hepatic hemangioma, and the treatment of hepatic hemangioma is not standardized enough in a few medical institutions. Therefore, it is necessary to briefly introduce the current situation of diagnosis and treatment of hepatic hemangioma by combining our clinical experience. Hepatic hemangioma is commonly referred to as cavernous hemangioma in adults, mostly due to developmental disorders of the hepatic blood sinuses at the embryonic stage. Hepatic hemangioma is the most common benign tumor of the liver, occurring between the ages of 30 and 50 years old, with a prevalence of 0.4%-20% in the population, mostly solitary, and multiple hepatic hemangiomas in about 10% of patients. Hepatic hemangioma usually has no clinical symptoms, but a few hemangiomas larger than 5 cm can cause symptoms such as hidden pain in the upper abdomen, feeling of fullness and indigestion. 1.Diagnosis of hepatic hemangioma Most of the hepatic hemangiomas are found accidentally during physical examination or abdominal imaging examination. Therefore, the diagnosis of hepatic hemangioma mainly relies on imaging examinations such as ultrasound, CT or MRI, etc. Ultrasound examination is the most common method to diagnose hepatic hemangioma, which has the advantages of simplicity, economy and convenience, and the accuracy rate of diagnosis is 70%-80%. CT or MRI-enhanced scan of the liver is more reliable for the diagnosis of hepatic hemangioma, especially MRI-enhanced scan, which has a sensitivity of 95% and a specificity close to 100% and can be used as a means to confirm the diagnosis. Therefore, for patients who are first diagnosed with hepatic hemangioma by ultrasound, if the tumor is not larger than 5 cm and there are no clinical symptoms, the ultrasound can be reviewed regularly in 3-6 months. If the tumor has an increasing trend or has a history of chronic hepatitis B, further enhanced CT or magnetic resonance examination should be performed to exclude the possibility of liver malignant tumor. 2.Treatment of hepatic hemangioma Hepatic hemangioma is a benign lesion in liver, most of the tumors increase slowly and do not become cancerous, and spontaneous rupture and bleeding of tumors rarely occurs (some people have counted the literature for more than 100 years and found that the total number of reported cases of spontaneous rupture and bleeding does not exceed 50, which is extremely rare), therefore, only a few patients with hepatic hemangioma need to receive treatment. Although there is no consensus on which patients with hepatic hemangiomas require surgical treatment, most surgical experts believe that treatment of hepatic hemangiomas should be approached with caution and that surgical treatment should be considered for patients with hepatic hemangiomas that: (1) cause severe clinical symptoms clearly associated with hepatic hemangiomas; (2) are large (greater than 8 cm) and have symptoms of compression; (3) are rapidly (4) Malignant lesions cannot be excluded; (5) Hepatic hemangiomas that are easily or already have symptoms of compression in special areas such as the hepatic portal, inferior vena cava and main veins in the liver parenchyma; (6) Serious complications such as rupture and bleeding. There are various treatment methods for hepatic hemangioma, including hepatic hemangioma debulking, hepatectomy, liver transplantation, hepatic artery interventional embolization, radiofrequency ablation and even drug treatment. Each treatment has its own potential risks and is not perfect, and needs to be chosen carefully and individually according to the patient’s specific situation. Surgical resection (hepatic hemangioma debulking, hepatectomy) is still the preferred and most effective treatment for hepatic hemangioma, and the safety of hepatectomy has been greatly improved. In recent years, laparoscopic hepatectomy for hepatic hemangioma is technically mature with the advantages of less trauma, less intraoperative bleeding, fewer postoperative complications, shorter hospital stay and faster recovery. Hepatic artery interventional embolization for hepatic hemangioma is mainly performed by occluding the blood supplying artery branch of hepatic hemangioma, causing fibrosis of hemangioma due to thrombus mechanization, terminating tumor growth, prompting tumor shrinkage and improvement of clinical symptoms to achieve treatment purpose, although avoiding surgery, but the efficacy is not yet exact. Mainly because of the complicated blood supply of hepatic hemangioma, it is often impossible to completely embolize the blood vessels, so the treatment effect is not complete and the recurrence rate is high. It also causes serious and even catastrophic complications such as liver abscess, intrahepatic bile duct necrosis, and septic cholangitis. It cannot and should not be used as a routine treatment for hepatic hemangioma treatment. Radiofrequency ablation treatment applies high-frequency current to make tissue ions vibrate and rub in the direction of the current, generating high heat to cause coagulative necrosis of tumor and achieve the effect of radical cure without removing tumor, which has the advantages of minimally invasive, simple, safe and repeatable. However, radiofrequency ablation has the advantages of limited tissue destruction, inaccurate treatment effect and high complications for huge hepatic hemangioma, and is limited by the location of hemangioma, so it is not used as the main treatment method for hepatic hemangioma at present. In conclusion, hepatic hemangioma is a common benign lesion, and ultrasound is the main follow-up examination. For patients with significant enlargement or unclear diagnosis, enhanced MRI or CT scan should be performed. Only a few patients with hepatic hemangioma require surgical treatment, and hepatectomy is currently the most effective treatment method, with laparoscopic liver resection preferred when available. Interventional embolization therapy and radiofrequency ablation are recommended as prudent options.