RFA is a technology that can be applied to unresectable hepatic malignancies without significant morbidity when patients and treatment approach are chosen carefully. The results of therapy provide patients with an improved chance for survival despite their unresectable disease. There are limitations of imaging to monitor treatment and treatment response. At this point, an intraoperative technique has greater treatment success than a percutaneous technique and this is likely associated with periprocedural imaging limitations with a percutaneous technique and the ability to more easily perform inflow vascular occlusion with an intraoperative approach. RFA is a potentially effective local tumor therapy for unresectable hepatic malignancies. Improved technology and concurrent application of RFA with other treatment modalities should continue to improve tumor response and patient survival for patients with unresectable hepatic malignancies.