Background: Liver trauma is one of the most common affected organs in blunt abdominal trauma. It is associated with a high rate of morbidity and mortality. Therefore, choosing the best modality for diagnosis and managing such high-risk patients is crucial. Objectives: In this study, we aim to review the literature focused on mechanism of liver trauma, pathophysiology, risk factors, diagnosis, and management with a focus on surgical approach. Methodology: PubMed database was used for articles selection using the following keywords: liver injury, and its management, and evaluation. Conclusion: Management of liver trauma patients depends on their status during the general assessment of the case. In hemodynamically unstable patients and those with gun-shot wounds, the first line is surgery. However, non-operative management remains the mainstay of therapy in blunt liver injury. The main rule dictating this decision is hemodynamic stability. Certain factors increase the risk of failed conservative therapy, and these should alert the surgeon to the possibility of conversion to the surgical intervention.