Background: The liver is the most frequently injured intraabdominal solid organ following trauma despite itsrelatively protected location.Due to its anatomical location, severe liver injuries usually lead to exsanguinatinghaemorrhage which is the most common cause of death.Methods:This is a retrospective and prospective study included A total of 100 patients with liver injuriespresented to (1- Accident and Emergency department, Kasr Alaini Hospital, Faculty of Medicine, Cairo University.2- Accident and Emergency department, New Kasr Alaini teaching Hospital, Faculty of Medicine, Cairo University.3- Hepato Pancreato Biliary unit, Freeman Hospital, Newcastle upon Tyne, UK) between January 2011 – July2013.Results:The age of the patients ranged from 9 years to 56 years. The patients included were 78 males and 22females.The most frequent cause of liver trauma was blunt trauma (50%) mainly RTA. The second most commoncause of liver trauma was penetrating trauma (42%). Iatrogenic injury occurred in 6% and spontaneous rupture in2%. Clinical evaluation of the 100 patients included in this study revealed that 64 patients were vitally stable(64%) following immediate resuscitation and 36 patients were vitally unstable despite resuscitation (36%). 62patients in this study underwent U/S. U/S was not done in 38 patients mostly because they were not stableenough to wait for the scan or because there were associated obvious injuries. Abdominal CT with IV contrastwas done in 46 patients. Grade I was the most common grade of liver injury 20%.The most commonly injuredliver segment was segment VII 38%.This study showed that 40 patients had associated injuries and 6 patients hadassociated hepatic vascular injury (hepatic vein, artery or IVC).The most common associated injuries werestomach 18% followed by spleen 10%.Among the included patients in this study 72 patients underwent operativemanagement representing 72%, 28 patients underwent non operative management representing 28%. Variousoperative techniques were adopted in this study including (Hepatorraphy, packing, segmentectomy, vascularrepair).All patients underwent non operative management had follow up CT scan with IV contrast during theirhospital stay. Two patients underwent angioembolization one of them was to control bleeding after initialpacking and the other one was as part of the conservative management.As per records, complications were infour patients 4% of total number, two of them developed jaundice and bile leakage and 2 developed bile leakagewithout jaundice, all underwent ERCP, sphincterotomy and stenting. One mortality was recorded. The length ofhospital stay ranged between 3-15 days with a mean of 7.5 days and median of 7.0 days. Follow-up informationwas available for all the patients over a period of 3 months after discharge; neither infective, late hemorrhagiccomplications nor incisional hernias were observed.Summary and conclusion:shock on admission, high grade of injury, high Injury Severity and presence ofassociated organ injury are associated with increased mortality rate and can be regarded as predictors ofoutcome. The management of injuries of the liver has evolved significantly. Non operative techniques for themanagement of stable patients have been established. Interventional radiological techniques have become morewidely used in patients who are being managed non operatively or who have been stabilized by perihepaticpacking. In unstable patients immediate control of bleeding is critical and the recommended techniques aremanual compression, Pringle maneuver and perihepatic packing. In terms of surgical management there hasbeen a definite move away from major, time consuming procedures toward conservative surgery and damagecontrol. The objective is to achieve a reduction in the mortality and the rate of complications. In mild trauma thisappears to have been achieved, however, this is difficult to do in extensive injuries with vascular involvement.The aim of this study was to analyze the different modalities, effectiveness, morbidity and mortality of both nonoperative and operative management in a series of patients with hepatic injury attended in our institutions.