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Objective: To investigate the optimizing of operative techniques on caveous hepatic hemangioma by comparing the effective of the two approaches (enucleation and hepatectomy). Methods: From May 1994 to September 2006, fortythree patients underwent the surgical removal of the caveous hepatic hemangioma were analyzed retrospectively. Enucleation was used for 16 cases and hepatectomy for 27 cases. The relative clinical data and operative factors between the two operative techniques were compared. Results: Statistically significant differences in tumor size, location and intraoperative blood lose between the two groups were observed (P < 0.05 ). Although enucleation was associated with less intraoperative bleeding and transfusion requirement but no significant differences in postoperative liver functional parameter, complication and length of hospital stay were observed. Conclusion: With proper choice, enucleation and hepatectomy both are effective treatments for caveous hepatic hemangiomas.