Between June 1, 1976 and Mar. 31, 1983, the Sunnybrook Medical Centre Regional Trauma Unit in Toronto, Ont., admitted 145 patients with liver trauma; of these, 141 (97%) had sustained blunt liver trauma. Of 113 patients who underwent open peritoneal lavage, 112 had a true-positive lavage. Resuscitation was successful in 137 patients and 134 of these underwent laparotomy. Seventy-nine (59%) of the 134 patients required only minor surgical treatment; the other 55 (41%) required major surgical procedures. The overall mortality was 32% (47 of 145). Eight patients died during resuscitation but only one of them died of liver hemorrhage. Of the 39 patients who died after admission, the cause of death was head injury in 22, while 6 died of liver hemorrhage and 11 of other causes. Overall, liver hemorrhage was the cause of death in 15% of cases (7 of 47).