Objective To evaluate the risk factors associated with massive bleeding during liver resection for hepatocellular carcinoma （HCC） and propose intraoperative nursing management. Methods A total of 1051 HCC patients undergoing liver resection were reviewed retrospectively. They were allocated into the massive bleeding group （n=170） and the non-massive bleeding group （n=881） according to intraoperative bleeding volume. Risk factors associated with massive bleeding during hepatectomy was identified by logistic regression analysis. Results Logistic multivariate analysis revealed that preoperative platelet count ＜100×109/L （OR=1.731）, tumor diameter ＞5.0 cm （OR=2.454）, portal vein tumor thrombus formation （OR=1.492） and major hepatectomy （OR=1.577） were the major risk factors linked to intraoperative massive bleeding （P＜0.05,P＜0.01）.The transfusion volume of red blood cell, fresh frozen plasma, crystal fluid in the massive bleeding group was significantly larger than those in the non-massive bleeding group （P＜0.01 for all）. Body temperature at the end of surgery was significantly lower, and duration of surgery was significantly longer in the massive bleeding group than the non-massive bleeding group （P＜0.01）. Conclusion In order to mi-nimize intraoperative blood loss,nurses need to fully understand the risk factors of massive bleeding during liver resection for HCC, reinforce pre-operative and intraoperative interventions, and take measures to avoid hypothermia.