Objective: To discuss the surgical strategy of giant cavernous hemangioma of the caudate lobe of the liver. Methods: The clinical treatment data of 4 patients with giant cavernous hemangioma of hepatic caudate lobe were retrospectively analyzed. Results: In all patients, the liver function was improved to Child-Pugh A, and CT scan with three-dimensional reconstruction was performed before surgery, to examine the anatomical relations of the tumor with the hepatic artery, hepatic vein and portal vein. The tumors in two patients were resected via right or left approach plus anterior transhepatic approach, while the other two cases were treated by left hemihepatectomy plus caudate lobectomy. The giant cavernous hemangiomas in all patients were resected safely and successfully, and no serious postoperative complications occurred. Conclusion: With comprehensive preoperative assessment and meticulous intraoperative techniques, surgical treatment is effective for giant cavernous hemangioma of the caudate lobe of the liver.