Transcatheter arterial embolization (TAE) was performed in 20 patients with ruptured hepatocellular carcinoma (HCC). Bleeding was improved in all patients, but only four survived for over three months. Rerupture occurred in seven patients (35%) and the prognosis was extremely poor. TAE should be considered the treatment of choice for ruptured HCC; however, long-term survival was limited to those patients without portal extension of HCC. The severity of rupture also influenced the prognosis.