Spontaneous rupture of hepatocellular carcinoma occurs frequently in populations in which this tumor is common, but rarely in populations with a low incidence of the tumor. Rupture caused by blunt abdominal trauma has previously been reported in a single patient only. We describe three southern African black men who presented with an acute hemoperitoneum after blunt trauma to the abdomen, and in whom a moderate-size hepatocellular carcinoma was found at laparotomy to have ruptured. In two of the patients, it was possible to resect the tumor. This resectability rate is unusual in blacks with hepatocellular carcinoma, because the tumor is characteristically far advanced at the time of presentation and is rarely amenable to resection.