Objective: To analyze the features of intratumoral microvessels (MV) in hepatocellular carcinoma with hemorrhagic/necrotic phenotype (HN-HCC). Methods: A total of 104 specimens of HCC were collected, which included 72 cases of HN-HCC and 32 cases of non-HN-HCC (NHN-HCC). Each HCC specimen was divided into 3 regions designated as the central region of the tumor, intermediate region between the core and margin of the tumor and marginal region of the tumor. The differences in morphological profiles of the intratumoral MV and mRNA expressions of angiogenesis-associated genes that included the BTB/POZ domain-containing protein 7 (BTBD7), hypoxia-inducible factor 1α (HIF-1α) and angiopoietin 2 (Ang-2) between the parallel regions of the two types of HCC were compared. Results: The patterns of the intratumoral MV were classified as vessels that encapsulated tumor clusters (VETC), capillary vessels (CV) and combined VETC and CV (VETC+CV). Comparison between the parallel regions of the two types of HCC showed that in each parallel region of HN-HCC compared with NHN-HCC, the VETC positive rate was increased (65% vs. 29%, 76% vs. 9%, 70% vs.16%), while the CV positive rate was decreased (23% vs. 55%, 3% vs. 72%, 11% vs. 59%) and all differences had statistical significance (all P<0.05), but the VETC+CV positive rate had no difference (all P>0.05); the mRNA expressions of BTBD7, HIF-1α, and Ang-2 were all significantly up-regulated (all P<0.05). Conclusion: There is disorder of intratumoral MV architecture with aberrant expressions of angiogenesis-associated genes in HN-HCC, which may induce local hypoxia and ischemia as well as tumor invasion and metastasis.