Background: Haemangiomas are the most common benign liver tumors. Treatment is indicated for   symptomatic tumors, rapid increase  in  size, rupture or  doubt in  diagnosis. Objective:Evaluation the efficacy of surgical treatment of giant cavernous hepatic haemangioma in tertiary hepatobiliary center. Patients and methods: Retrospective study of 34 patients with giant hepatic haemangioma operated on. The diagnosis was  proved  preoperatively in 27 patients  and  confirmed by histopathology postoperatively in all patients. The indication of surgery was abdominal pain with large sizes tumors, rapid growth, and spontaneous rupture with haemoperitoneum.Surgical treatment either liver resection or living liver transplantation. Results:  33 cases (67.6%)  were females &11cases  (32.4%)  were males, median age 38.8 years. Haemangiomas were located in right lobe in 19 patients(55.9%), left lobe in 12 patients (35.4%) in both lobes in 2 patients (5.8%), scattered all over  both lobe in one patient(2.9%), solitary  in 27 cases (79.4%)  and multiple in 7 patients (20.6%).The diameter  was 8-27 em, mean 18.6 em in diameter. 33 patients had liver resection (29 elective resection and 4 emergent resection for rupture). One patient had haemangioma irresectable,· the living liver transplant was peiformed. No mortality occurred during 18 months follow up and complications occurred in 8 patients out of 34 patients. Conclusion: Hepatic resection is an effective treatment option for giant cavernous hepatic haemangioma and in selected patients, living related liver transplantation may be the only therapeutic option.