【Abstract】Objective To investigate the role of thromboelastography (TEG) in clinical transfusion of patients with hepatic coagulation after liver cancer and its influence on coagulation parameters and blood coagulation quality. 〖WTHZ〗Methods〖WTBZ〗 From August 2017 to July 2019, 120 patients with postoperative coagulation dysfunction of liver cancer in our hospital were randomly divided into observation group and control group, 60 cases in each group. The control group received blood transfusion according to the routine coagulation index, and the observation group received blood transfusion according to the test results of TEG. The results of TEG before and after blood transfusion ［coagulation reaction time (R), clot formation time (k), αangle, coagulation composite index (CI)］ in the observation group were compared. The blood coagulation indexes ［(prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen (FIB)］, blood transfusion varieties and quantity, bleeding or bleeding time, bleeding or bleeding volume before and after blood transfusion were compared between the two groups. Results The values of R, K and αangle, MA, CI in the observation group were lower than those before transfusion (P＜005). There was no significant difference in PT, APTT, TT and FIB between the observation group and the control group (P＞005). Compared with before transfusion, PT, APTT and TT in the two groups were all decreased, and the values in the observation group were lower than those in the control group (P＜005). The FIB of the two groups was higher than that of the control group (P＜005). The dosage of CRC and FFB in the observation group was lower than that in the control group, the dosage of cryo and PC in the observation group was higher than that in the control group, the time of bleeding or bleeding was shorter than that in the control group, and the amount of bleeding or bleeding was less than that in the control group (P＜005). Conclusion The application of TEG to guide clinical transfusion in patients with liver cancer after coagulation abnormality can effectively improve blood coagulation index and blood coagulation quality, help guide blood transfusion and rational use of blood resources.