Objective: To investigate the safety and feasibility of hyperthermic intraperitoneal chemoperfusion (HIPEC) in treatment of spontaneous rupture/hemorrhage of hepatocellular carcinoma in children. Methods: The clinical and follow-up data of one pediatric patient with spontaneous rupture/hemorrhage of hepatocellular carcinoma were retrospectively analyzed and the relevant literature was reviewed. Results: The 10-year old female patient underwent emergency interventional embolization therapy for hemostasis due to rupture of intrahepatic tumor in other hospital, and received cholecystectomy and hemihepatectomy combined with HIPEC (10 mg pirarubicin diluted in 3 000 mL 5% glucose, circulated for 40 min at 41 °C) 6 days later in the Department of Hepatobiliary Surgery of Hunan Provincial People’s Hospital. The operation was uneventfully performed and no complications occurred during the perioperative period. The postoperative pathology confirmed a grade III hepatocellular carcinoma with R0 resection margin. Subsequently, the patient was transferred to the Department of Pediatric Hematological Oncology and received chemotherapy using a FOLFOX4 regimen. Follow-up examinations at 11 months after operation showed that the AFP was 9.56 ng/mL, the HBV-DNA was under 100 IU/mL, and no tumor recurrence occurred as evidenced by upper abdominal MRI. Conclusion: Surgical resection combined with HIPEC is safe and feasible for the treatment of spontaneous rupture/hemorrhage of hepatocellular carcinoma in children, with satisfactory short-term results.