Objective: To investigate the clinical efficacy of selective hepatic artery embolization in treatment of grade III or IV liver trauma. Methods: The clinical data of 19 patients with grade III or IV liver trauma undergoing hepatic artery embolization (intervention group) from January 2006 to October 2016, and 19 comparable patients with grade III or IV liver trauma undergoing open surgery (laparotomy group) treated during the same period were retrospectively analyzed. The relevant clinical variables between the two groups of patients were compared. Results: Operations were successfully performed in both groups of patients. The postoperative serum transaminase and creatinine levels were significantly lower and the time for aminotransferase to return to normal was significantly shorter in intervention group than those in laparotomy group (all P<0.05); in intervention group compared with laparotomy group, the operative time (60.74 min vs. 128.11 min), postoperative fasting time (34.03 h vs. 56.00 h), length of hospital stay (13.58 d vs. 18.37 d) and hospitalization costs (34 860.90 yuan vs. 54 141.47 yuan) as well as incidence of complications (10.5% vs. 57.9%) were all significantly reduced (all P<0.05). No significant difference was noted in other clinical variables between the two groups (all P>0.05). Conclusion: Selective hepatic arterial embolization is a safe and effective method for grade III and IV liver trauma. For grade III or IV liver lacerations with stable hemodynamics or hemodynamic stability obtained after aggressive anti-shock therapy and blood or fluid transfusion, selection of interventional angiography is recommended.