Background: The liver is one of the most damaged organs and a common cause of death after blunt abdominal trauma. Conservative treatment becomes now the treatment of choice in hemodynamic stable patients. Aim of work: To assess the safety and efficacy of Non-Operative versus Operative Strategy in management of patients with liver blunt trauma. Subjects and methods: This study was a prospective study that included 61 patients with blunt liver trauma admitted to the Emergency Department in Zagazig University Hospitals during the period from February 2017 to February 2019. Management options divided into two groups, group I (non-operative management" NOM") and group II (Operative management "OM"). All data were collected including age, sex, mechanism of injury, grades of hepatic trauma, treatment options, complications, and length of hospital stay. Results: 60% of the operative group vs 9.7% only in the conservative group had a high-grade injury. Conservative treatment was succeeded in all patients. The operative management group showed more post-operative complications comprised [bile leak 13.3%, pneumonia 20%, wound infection 13.3%, localized collection, and ascites in 6.7%] and mortality was 13.3% due to pulmonary embolism or shock. Conclusion: Conservative management is efficient in the management of patients with hemodynamic stability and high-grade liver injury with accepted morbidity. Operative management should be restricted in unstable patients with blunt liver trauma.