Abstract: Objective: To summarize clinical features, experience of diagnosis and treatment of rupture hepatocellular carcinoma（HCC）. Methods: Eight patients with ruptured HCC who were surgically or conservatively treated were retrospectively analyzed in terms of clinical features, modality of treatment, survival time, and cause of death. Results: The patients were admitted to the hospital from 1987 to 2002, accouting for 11.42%（8/70） of all hospitalized patients with HCC in the same period. Out of them seven patients were male, one patient was female. Sudden epigastric or right hypochondriac pain which decrease gradually with sweat, nausea, vomiting, hypotension and diarrhea. Blood pressures were lower than 90/60 mmHg in 6 patients and 87.5%（7/8） have signs of peritonitis. Blood-stained ascites exists in all cases and abdominal paracentesis is positive in overall. Median survival time were 54 days（range, 5 h～2 731 days）. One patient, who was treated by emergent transcatheter arterial embolization（TAE）, is still alive and well now in 6 months. One patient, who surgical resection was performed after hemostasis, had a survival time as long as 2 731 days. Six patients died in the hospital. Rebleeding was found in 4 hospitalized patients and was treated with conservative measures, resulting in all deaths. Conclusion: Ruptured HCC should be suspected in any patient with acute epigastric pain. Abdominal paracentesis should be performed. BUS, CT is valuable in the diagnosis of ruptured HCC because it is non-invasive procedure. While TAE remains the best method to employ for hemostasis, it still has limitations. Hence, we should be mindful of other possible modalities for hemostasis and their outcomes.