Rupture of hepatocellular carcinoma associated with pregnancy is highly unusual. We report herein 3 cases found incidentally during emergency obstetric surgery. All the 3 patients were in their second or third trimester, had no history of contraceptive pill usage, and proved to have hepatitis B virus infection or liver cirrhosis. One of patients had a history of blunt trauma, another patient presented as an acute abdomen. Hemostasis was achieved by suture plication and right hepatic artery ligation in 2 patients, and bisegmentectomy in another one. Live infants were delivered in 2 cases, another one was stable during the surgery and termination of the pregnancy was performed postoperatively. The maternal outcome was grave, 2 of the patients succumbed to aggressive hepatocellular carcinoma in a short time after the operation. A special challenge is imposed on the physician when confronted by this condition as 2 lives are involved. All the 3 patients were in their second or third trimester, had no history of contraceptive pill usage, and proved to have hepatitis B virus One of patients had a history of blunt trauma, another patient presented as an acute abdomen. Hemostasis was achieved by suture plication and right hepatic artery ligation in 2 patients, and bisegmentectomy in another one. Live infants were delivered in 2 cases, another one was stable during the surgery and termination of the pregnancy was performed postoperatively. The maternal outcome was grave, 2 of the patients succumbed to aggressive hepatocellular carcinoma in a short time after the operation. A special challenge is imposed on the physician when confronted by this condition as 2 lives are involved.