Objective: To compare the efficacy of microwave ablation and hepatic arterial embolization for hepatic hemangioma. Methods: Seventy patients with liver hemangioma admitted between January 2009 and April 2012 were randomly assigned to ablation group (37 cases undergoing microwave ablation of the liver hemangioma by ultrasonography guided percutaneous approach under local anesthesia or laparoscopic puncture under general anesthesia) and embolization group (33 cases undergoing super-selective embolization of the liver hemangioma with pingyangmycin-lipiodol emulsion). The therapeutic effects between the two treatment methods were compared. Results: Six months after treatment, 9 patients (24.32%) in ablation group had residual blood supply to the lesions, and underwent a second microwave ablation treatment, while 18 patients (54.55%) in embolization group had residual blood supply to the lesions and received a second treatment (13 cases underwent hepatic artery embolization and 5 cases underwent microwave ablation). At follow-up of 12 months after treatment, in ablation group, 31 patients (83.78%) had reduction in tumor size by more than 75%, with complete disappearance of blood supply to the tumor and 6 patients (16.22%) whose reduction of tumor size was less than 75% showed that most of the blood supply to the tumor had disappeared; in embolization group, tumor size in 15 patients was reduced by more than 75%, and blood supply to the tumor had completely disappeared, whereas the 18 patients (54.55%) who underwent the second treatment had less than 75% reduction of tumor size, and most of the blood supply to the tumor had disappeared. The difference between the two groups had statistical significance (P<0.01). Conclusion: Microwave ablation has reliable efficacy for hepatic hemangioma, which is better than hepatic arterial embolization in reducing tumor size and blood supply to the lesion.