Hepatic epithelioid hemangioendothelioma (HEH) is a rare low-grade tumor of vascular origin with a malignant potential between benign hemangioma and malignant hemangioendotheliosarcoma. We analyzed 300 published cases and described our 4 female patients with hepatic EH that were treated curatively in our institution. Four female patients with HEH were treated by liver transplantation (LTx)(n=3) and right-sided hemihepatectomy (n=1). No adjuvant chemotherapy was applied. Till present with follow up periods from 9 months to 12 years, no tumor recurrences could be observed. In the literature, most patients presented with right upper abdominal pain and/or weight loss. In most cases, the tumor had spread throughout the liver, presenting as multiple nodular lesions. About 27-45% of tumors metastasized, mostly to the lungs and bones. The keys towards diagnosis included detection of cells expressing factor VIII-related antigens. The 5-year overall survival rate was 43-55%. For HEH patients, early detection and surgical intervention can offer a curative treatment. Radical liver resection and LTx are treatments of choice. Most commonly, the patients need LTx because of the widespread nature of this tumor in the liver. In comparison to other malignant tumors of the liver, its 5-year survival rate is significantly higher.