Hepatic hemangioma is the most common benign tumor of the liver. The exact cause of its development is unknown, but it is generally believed to be a congenital developmental abnormality. During embryonic development, hemangioma is formed due to abnormal development of blood vessels, causing tumor-like proliferation. Its clinical manifestations vary according to the size of the tumor, the site of occurrence, the growth rate, the patient’s general condition and the degree of liver tissue damage. When the tumor is small, there is no clinical symptom, and it is mostly discovered by chance when ultrasound, CT, MRI and other imaging examinations are performed for other diseases or when dissection is performed. Among patients with symptomatic hemangioma, the most common symptom is abdominal pain, which manifests as chronic hidden pain or distension, mostly due to rapid growth of the tumor, pulling the liver envelope or combined with thrombosis. When the tumor gradually increases and presses the neighboring organs, symptoms such as upper abdominal discomfort, abdominal distension, hidden pain in upper abdomen and belching may appear. Hepatic hemangioma is not malignant and the treatment depends on the patient’s age, the size, location and growth rate of the tumor. For hemangiomas less than 5cm in diameter and without any clinical symptoms and growing in the liver parenchyma, they can be followed up on an outpatient basis, and the changes of the tumor can be observed by ultrasound in the hospital every year without special treatment. If the tumor is larger than 7-8 cm in diameter or has clinical symptoms, or if the tumor is growing and has symptoms of compression on surrounding organs, or if the tumor is growing rapidly (more than 1 cm per year), or if it has adverse effects on the cardiovascular system, or if it is estimated that the tumor may rupture and endanger life (in fact, the possibility of rupture is very small), or if it cannot be distinguished from malignant tumors, effective treatment should be performed. Even if the tumor is large, it may be left untreated if it is asymptomatic or if the symptoms are mild and do not affect daily life. It is important to note that the main risk of hemangioma comes from the liver surgery itself, so both doctors and patients must think twice before choosing surgery. There is no specific drug for hepatic hemangioma, and surgical treatment is preferred, either by hepatectomy or extraperitoneal hemangioma debulking. Extraperitoneal resection is the most ideal treatment because it can completely remove the tumor while preserving the normal liver parenchyma. We treat dozens of cases each year, and the procedure can be completed in 3-5 minutes in the fastest cases. 95% of patients do not need blood transfusion. Patients can be discharged from the hospital in 7-10 days after surgery. As for interventional treatment, the results are not definite, and if the embolic agent is not chosen properly, it may embolize the vessels of the biliary tract, causing serious consequences, which may lead to sclerosing cholangitis-like changes in the long term, or even require a liver transplant. So-called puncture biopsies are prohibited for suspected hepatic hemangiomas, especially if they are superficially located, and so-called ultrasound-guided puncture injections should be avoided because they are life-threatening if the peritoneum is pierced and intra-abdominal hemorrhage occurs, and the injections themselves are not effective. It is also worth mentioning that when ultrasound examination is done for giant hemangioma on the liver surface, the doctor must be gentle and should not press the tumor with the ultrasound probe, otherwise it may lead to the rupture of the tumor envelope and death.