BACKGROUND/AIMS: Hemoperitoneum due to spontaneous rupture of hepatocellular carcinoma (HCC) is a life-threatening condition. This study was aimed to understand the clinical features of patients with ruptured HCC and to evaluate the prognostic factors influencing survival. METHODS: Among 624 cases with HCC who visited the Samsung Medical Center from July, 1995 to June, 1997, 30 case (4.8%) were diagnosed as hemoperitoneum due to rupture of HCC. The clinical records and radio logic findings were reviewed retrospectively. RESULTS: The median survival was 23 days (1-150) and the most common cause of death was liver failure (43.5%). The median survival of the patients trea ted by transarterial embolization (TAE) was significantly longer than that of the patients treated con servatively (97 vs. 10 days, p=0.03). In univariate analysis of factors influencing survival, the tumo size (p=0.04) and treatment modality (p=0.03) influenced the survival, whereas Child' s class, presence of portal vein invasion and type of tumor did not. In multivariate analysis, treatment modality wa the only significant factor which influenced the survival (p=0.01). CONCLUSIONS: The patients with rupture of HCC showed poor prognosis with median survival of only 23 days and the main cause of death was liver failure. TAE may prolong survival but further prospective studies are needed to prove its role.