Objective: To assess the clinical efficacy of laparoscopic microwave ablation for symptomatic hepatic hemangioma less than 10 cm in diameter. Methods: The clinical data of 145 patients with hepatic hemangioma admitted to Tongji Hospital of Huazhong University of Science and Technology from January 2011 to January 2014 were analyzed. Of the patients, 58 patients underwent laparoscopic microwave ablation (laparoscopic microwave ablation group), while the other 87 patients underwent surgical resection (surgical resection group). The short-term and long-term outcomes of the two methods of treatment for hepatic hemangioma were evaluated. Results: The preoperative data of the two groups of patients were comparable. In laparoscopic microwave ablation group, the variables that included operative time, intraoperative blood loss, number of cases requiring blood transfusion, incidence of postoperative complications, and length of postoperative hospital stay were all superior to those in surgical resection group (all P<0.05), while the symptom- eliminating efficacy was similar to that in surgical resection group. All patients were followed up, and no recurrence was noted. Conclusion: Laparoscopic microwave ablation has proven efficacy in treatment of symptomatic hepatic hemangioma with diameter less than 10 cm, with advantages of being safe, minimal invasiveness, and less complications.