We present an essentially Lagrangian hydrodynamic scheme suitable for modeling complex compressible flows on tetrahedron meshes. The scheme reduces to a purely Lagrangian approach when the flow is linear or if the mesh size is equal to zero; as a result, we use the term essentially Lagrangian for the proposed approach. The motivation for developing a hydrodynamic method for tetrahedron meshes is because tetrahedron meshes have some advantages over other mesh topologies. Notable advantages include reduced complexity in generating conformal meshes, reduced complexity in mesh reconnection, and preserving tetrahedron cells with automatic mesh refinement. A challenge, however, is tetrahedron meshes do not correctly deform with a lower order (i.e. piecewise constant) staggered-grid hydrodynamic scheme (SGH) or with a cell-centered hydrodynamic (CCH) scheme. The SGH and CCH approaches calculate the strain via the tetrahedron, which can cause artificial stiffness on large deformation problems. To resolve the stiffness problem, we adopt the point-centered hydrodynamic approach (PCH) and calculate the evolution of the flow via an integration path around the node. The PCH approach stores the conserved variables (mass, momentum, and total energy) at the node. The evolution equations for momentum and total energy are discretized using an edge-based finite element (FE) approach with linear basis functions. A multidirectional Riemann-like problem is introduced at the center of the tetrahedron to account for discontinuities in the flow such as a shock. Conservation is enforced at each tetrahedron center. The multidimensional Riemann-like problem used here is based on Lagrangian CCH work [8,19,37,38,44] and recent Lagrangian SGH work [33–35,39,45]. In addition, an approximate 1D Riemann problem is solved on each face of the nodal control volume to advect mass, momentum, and total energy. The 1D Riemann problem produces fluxes [18] that remove a volume error in the PCH discretization. A 2-stage Runge–Kutta method is used to evolve the solution in time. The details of the new hydrodynamic scheme are discussed; likewise, results from numerical test problems are presented.