Background: Hepatic epithelioid angiomyolipomas (HEAMLs) are rare and usually arise in case reports, and thus, we aimed to study the clinicopathological features, treatment and prognosis of these lesions. Methods: We identified patients from institutional database with HEAMLs and retrospectively collected clinical data. Results: Of 12 patients, 10 were females, and the median age was 49 years. A liver mass was found on chance upon routine health screening in nine patients. Imaging features included clear border (9/12), internal heterogeneity (8/12), arterial enhancement (12/12), fat (5/12), intra‐tumour vessel (3/12), draining hepatic vein (2/12) and pseudocapsule (1/12). The preoperative diagnoses contained HEAML (n = 5), hepatocellular carcinoma (n = 6), and hepatic cystadenocarcinoma (n = 1). All cases had received surgery and obtained a negative margin. All specimens showed positive findings for HMB‐45 and Melan A. No tumour recurrence or mortality was described with a mean follow‐up time of 23.5 months. Conclusions: HEAML is a low potential malignancy tumour that frequently appears in middle‐aged females. It has nonspecific symptoms and may present special imaging features including intra‐tumour vessel, early draining hepatic vein and lack of a pseudo capsule. The lesion is confirmed by pathological and immunohistochemical findings. Surgery and subsequent long‐term follow‐up are the most appropriate management approaches. [ABSTRACT FROM AUTHOR]