Objective: To investigate the efficacy and technical aspects of laparoscopic microwave ablation in treatment of giant hepatic hemangioma. Methods: The clinical data of 86 patients with hepatic hemangioma larger than 5 cm in diameter undergoing laparoscopic microwave ablation from January 2015 to December 2015 were retrospectively analyzed. Results: Laparoscopic microwave ablations were performed successfully in all the 86 patients without any open conversion. The average ablation time was (26.4±2.7) min, average blood loss was (27.6±5.2) mL and average length of postoperative hospital stay was (3.7±1.4) d. The complications included hemoglobinuria in 20 cases (23.3%), skin burns in 3 cases (3.5%), fever in 11 cases (12.8%), and pneumothorax in one case (1.2%), but no serious complications such as postoperative hemorrhage, bile leakage and adjacent organ injuries occurred. Postoperative follow-up was conducted for 6 to 12 months. There were 82 cases (95.3%) with residual hemangioma lesion of less than 10%, 3 cases (3.5%) with residual lesion ranging from 10% to 15%, and one case (1.2%) with residual lesion more than 15%. Conclusion: Laparoscopic microwave ablation is safe and effective in treatment of giant hepatic hemangioma, and it is recommended to be used in clinical practice.