本文报告了3例肝原发性平滑肌肉瘤，男性1例，女性2例。平均年龄38．7岁。占同期肝恶性肿瘤检出率的0．68%（3／436），占同期肝恶性间叶组织肿瘤检出率的25%（3/12）。临床表现为上腹痛、右上腹包块、肝大。本组病例还进行了Masson三色染色及免疫组化染色。本文结合文献对肝原发性平滑肌肉瘤的组织发生、临床病理特点及诊断、鉴别诊断进行了讨论。 This article reports 3 cases of primary liver leiomyosarcoma, 1 male and 2 female. The average age is 38.7 years old. It accounted for 0.68% (3/436) of the detection rate of hepatic malignancies at the same time, accounting for 25% (3/12) of the detection rate of hepatic malignant interlobular tissue tumors at the same period. The clinical manifestations of upper abdominal pain, right upper abdominal mass, hepatomegaly. Masson trichrome staining and immunohistochemical staining were also performed in this group of patients. In this paper, the histogenesis, clinicopathological features, diagnosis and differential diagnosis of primary leiomyosarcoma of the liver are discussed.