Objective To investigate the safety of thermal ablation for primary liver cancer patients with evident abnormal coagulation function.Methods Clinical data of 37 primary liver cancer patients undergoing thermal ablation in the Third Affiliated Hospital of Sun Yat-sen University from March 2016 to August 2018 were retrospectively analyzed.31 cases were male and 6 were female,aged 28 to 85 years with a median age of 55 years.The prothrombin time (PT) was prolonged for more than 3 s.The informed consents of all patients were obtained and the local ethical committee approval was received.Before operation,the esophageal and gastric varices was treated with gastroscopy and acid inhibitors were also given.Intraoperatively,abdominal bleeding was observed by artificial ascites.The needle-tract bleeding was treated and the hemostatic effect was evaluated under the guidance of contrast-enhanced ultrasound (CEUS).The postoperative incidence was observed.At postoperative 1 month,the effect of ablation was evaluated by CT/MRI.Results A total of 55 lesions in 37 patients were successfully treated by thermal ablation.Immediate CEUS indicated 2 cases of needle-tract bleeding after thermal ablation.Hemostasis was performed successfully in both cases by needle-tract ablation under the guidance of CEUS,and no other bleeding complications occurred after ablation.At 1 month after thermal ablation,CT/MRI demonstrated that all lesions were completely ablated.Conclusions Under the strict perioperative management and monitoring,liver cancer patients with obvious abnormal coagulation function can be treated with thermal ablation safely with favorable effect.