Objective To explore the diagnosis and treatment for spontaneous rhexis hemorrhage of liver cancer. Methods Clinical data of thirty patients who suffered from spontaneous rhexis hemorrhage of liver cancer from January 1995 to March 2009 were collected and analyzed retrospectively. Results Twenty-six cases were stanched by surgical therapy, in which 14 cases underwent liver cancer resection, 10 cases underwent bleeding transfixion and hepatic artery ligation (or intubation), and 2 cases underwent omentum stuff transfixion. Four cases died one week after surgery, one died after 15 d, 9 cases died 1 to 3 months after operation, 5 cases survived after 4 to 6 months, 3 cases survived after 7 to 12 months, and in 4 cases survival time was longer than 12 months (in which one patient’s survival time was 16 months, one was 5 years and two patients were still alive with survival time of 3 and 13 years respectively). Four patiens went through the non-surgical therapy and survival time was 3 to 14 d. Conclusion The spontaneous rhexis hemorrhage of the liver cancer is not the telephase of the liver cancer. Early diagnosis and operation can stanch bleeding effectively. The surgical therapy is better than the non-surgical therapy. Resection of liver neoplasms in time can raise long-term survival time.