Objective:To analyze the risk factors,prevention and treatment of needle-tract bleeding after percutaneous image-guided radiofrequency ablation (PRFA) for hepatocellular carcinomas (HCC).Methods: A total of 1 567 RFA sessions were performed on 1 203 patients with 3 067 focuses of hepatocellular carcinoma between December 1999 and January of 2008.The clinical data of patients suffering from needle-tract bleeding were analyzed for risk factors,prevention,and treatment.Results: Seventeen (1.08%,17/1 567) patients developed needle-tract bleeding.Univariate analysis showed that the incidence of needle-tract bleeding was significantly correlated with the lower platelet count,prolongation of prothrombin time,the degree of liver cirrhosis,subcapsular HCCs and pattern of RF needle electrode (P=0.039; P=0.023; P=0.012; P=0.032 and P=0.016,respectively).Logistic regression model found that only lower platelet count,prolongation of prothrombin time,degree of liver cirrhosis and subcapsular HCCs were the independent risk factors for needle-tract bleeding after PRFA in patients with hepatocellular carcinoma (OR=4.032,P=0.040;OR=5.611,P=0.009;OR=3.871,P=0.046 and OR=5.216,P=0.026,respectively).Of the 17 patients 5 received only medicine therapy in the internal department,4 received surgery and 10 received transcatheter embolization.Thirteen patients survived and 4 died.Conclusion: It is indicated that prolongation of prothrombin time,lower platelet count,sub-capsular HCCs and pattern of RF needle electrode can influence the needle-tract bleeding after PRFA in hepatocellular carcinoma patients.The most effective methods to control the bleeding are transcatheter embolization and DSA or surgery for HCC patients after PRFA.