Abstract: Objective To investigate the diagnosis and treatment of adult rare liver tumors or tumor-like lesins. Methods The clinical data of 18 cases of rare liver tumors or tumor-like lesions were collected from June 2009 to May 2015. The clinical diagnosis and treatment of various types of liver tumors or tumor-like lesions were analyzed retrospectively. Results In 18 cases of adult rare liver tumors or tumor-like lesions，there were 2 cases of fibrous tumor，3 cases of adenoma，4 cases of focal nodular hyperplasia，2 cases of carcinosarcoma，2 cases of liver hamartoma，2 cases of inflammatory pseudotumor，1 case of spindle cell tumor，1 case of primary malignant liver mesenchymal tumor，and 1 case of hepatic tuberculosis. Imaging misdiagnosis occurred in 8 cases, and the diagnostic accuracy of benign and malignant lesions was 50%.CA19-9 was significantly increased（246.4 kU／L）in 1 cases of inflammatory pseudo tumor，and the tumor markers were normal in other cases. One adenoma case underwent radiofrequency ablation and one hepatic tuberculosis case did not undergo tumor resection and other cases underwent liver lesions complete resection（including local resection and hepatic segmental resection）. Conclusion The rare liver tumors are difficult to diagnose preoperatively，and the misdiagnosis rate is high. Diagnosis is mainly based on the pathological indicators. Surgery is the main therapy for rare liver tumors or tumor-like lesions.