To evaluate the long-term efficacy and safety of treating polycystic liver (PLD) with superselective hepatic artery embolization (TAE). Methods Superselective hepatic artery embolization was performed in 23 patients with severe symptomatic PLD. The patients were 19 female and 4 male, aged 36.0-68.0 years, with a mean of (49.3±3.4) years. All patients underwent CT plain + enhanced scans of the upper abdomen before and after TAE: CT was repeated at the 3rd month, 6th month after TAE and at six-month intervals thereafter. 23 patients underwent a total of 27 interventions, with a technical success rate of 100% and a median follow-up of 19 months (3-58 months), 2 cases were ineffective, and 21 cases were available for evaluation of efficacy, with an efficiency rate of 91.2%. The mean abdominal circumference of the patients was (105.7±8.1) cm before surgery and (95.2±6.7) cm after surgery, with a statistical difference in the mean abdominal circumference before and after surgery (P<0.001). The mean abdominal circumference began to shrink at (8.0±3.5) months and the symptoms improved at (7.1±2.2) months; the post-embolization syndrome mostly resolved within 7 d after embolization, and the liver function was at normal level at the 6th postoperative day and long-term reexamination.TAE treatment for polycystic liver has reliable long-term efficacy and high safety, and is worthy of further clinical promotion and application.