Objective: To investigate the clinical features of undifferentiated embryonal sarcoma of the liver (UESL) to improve its preoperative diagnostic accuracy. Methods: Retrospectively analysis the clinical, imaging and histopathologic findings of 16 cases preoperatively misdiagnosed UESL which were all pathologically confirmed. Results: Among these 16 cases, clinically diagnosed primary liver carcinoma 9 cases, hepatoblastoma 3 cases, malignant hepatic tumor 4 cases. Twelve patients mainly presented abdominal discomfort. Sonograms revealed predominant solid lesions; CT and MRI demonstrated predominant cystic masses within irregular soft tissue. Contrast-enhanced images showed intralesional foci, multiple internal septations andedges enhancement. The postoperative pathology showed the cut surface of tumors was variegated, with solid and cystic gelatinous areas, hemorrhage and necrosis. Intracytoplasmic hyaline globules were commonly present among cancer cells. Conclusion: UESL is a rare malignancy of the liver with no specific clinical manifestation, imaging finding inconsistent between ultrasound, CT and MRI which might be helpful to improve the preoperative diagnosis accuracy.