Abstract: Objective To compare the therapeutic effect of emergency transcatheter arterial embolization(TAE) plus two-stage liver resection with emergency liver resection for spontaneous ruptured hepatocellular carcinoma(HCC). Methods We collected the medical literatures published at home and abroad concerning the clinical results of emergency TAE plus two-stage liver resection and emergency liver resection in treating spontaneous ruptured HCC through electronic or manual searching. Literatures that met the inclusion criteria were reviewed systematically, and the reported data were aggregated statistically using RevMan5.3 software. Results A total of 5 academic papers were enrolled. The complication rate of emergency TAE plus two-stage liver resection group was significantly lower than that of emergency liver resection group(OR=0.27, 95%CI:0.03-0.40, P=0.008); moreover, no significant difference in 1-, 2-,3-year survival rate existed between two groups(1-year survival rate: OR=1.63, 95%CI:0.84-3.16, P=0.15; 2-year survival rate: OR=1.40, 95%CI:0.63-3.11, P=0.41; 3-year survival rate: OR=1.13, 95%CI:0.48-2.68, P=0.78). Conclusion Emergency TAE combined with two-stage liver resection could reduce perioperative complication rate and make patients get the greater benefit after surgery in the short term, compared with emergency liver resection in treating ruptured HCC.