From Jan 1, 1971 through June 30, 1979, 113 cases of massive liver injury were managed by insertion of a viable omental pack. Significant active hemorrhage was present in all cases, while the source of hepatic bleeding was primarily venous in the 102 injuries due to blunt trauma. Associated injuries were present in 90% of patients, with an average of 2.4 associated injuries per patient. A total of 175 complications developed in 82 patients. Nine deaths produced a mortality of 8%. Arrest of liver hemorrhage by tamponade with viable omentum was almost uniformly successful in patients with nonpenetrating injury.