BACKGROUND: Spontaneous rupture of liver tumor is often considered a potentially life-threatening situation. The aim of the present study was to assess re-operation after emergency repair of ruptured liver cancer. METHODS: We reviewed retrospectively five patients who had been admitted within a one-year period and undergone a second operation after emergency repair of primary liver cancer rupture. RESULTS: Five patients (4 males and 1 female) underwent emergency repair of ruptured liver cancer in local hospitals; three of them received transarterial chemoembolization (TACE). The tumor was in the right hepatic lobe in 2 patients, middle lobe in 1, left median lobe (segment Ⅳ) in 1, and caudate lobe (segment Ⅰ) in 1. Operative methods included right hemihepatectomy in 2 patients, left partial lobectomy or wedge resection in 1, caudate lobe resection in 1, and middle lobctomy+cho-lecystectomy+abdominal implant resection in 1. Intra-abdominal chemotherapy was given to all 5 patients. Follow-up showed that one patient died from intrahepatic metastasis and hepatic failure six months after re-operation and that two patients died from extensive intra-abdominal metastases six months later. The remaining two patients have been surviving for 28 months. CONCLUSIONS: Re-operation is indicated for patients with primary liver cancer rupture whose liver function is good and whose foci are localized and operable. Apart from removing the primary foci, it is necessary to clearabdominal metastatic foci, irrigate the abdomen and administer chemotherapy to prolong the patient’s life. BACKGROUND: Spontaneous rupture of liver tumor is often considered a potentially life-threatening situation. The aim of the present study was to assess re-operation after emergency repair of ruptured liver cancer. METHODS: We reviewed retrospectively five patients who had been admitted within a one-year period and undergone a second operation after emergency repair of primary liver cancer rupture. RESULTS: Five patients (4 males and 1 female) underwent emergency repair of ruptured liver cancer in local hospitals; three of them received transarterial chemoembolization (TACE). The tumor was in the right hepatic lobe in 2 patients, middle lobe in 1, left median lobe (segment IV) in 1, and caudate lobe (segment I) in 1. Operative methods included right hemihepatectomy in 2 patients, left partial lobectomy or wedge resection in 1, caudate lobe resection in 1, and middle lobctomy + cho-lecystectomy + abdominal implant resection in 1. Intra-abdominal chemotherapy was given to all 5 patients. F ollow-up showed that one patient died from intrahepatic metastasis and hepatic failure six months after re-operation and that two patients died from extensive intra-abdominal metastases six months later. The remaining two patients have been survived for 28 months. CONCLUSIONS: Re- operation is indicated for patients with primary liver cancer rupture whose liver function is good and whose foci are localized and operable. Apart from removing the primary foci, it is necessary to clearabdominal metastatic foci, irrigate the abdomen and administer chemotherapy to prolong the patient’s life.