The incidence rate of hepatocellular carcinoma (HCC) has been increasing over the last 20 years. HCC is a worldwide, but the incidence is very high in countries of South East Asia, China, sub-Saharan Africa and southern Europe. Liver cirrhosis is the most important risk factor for the development of HCC, through necrotic-proliferative and dysplastic activity. HBV is indicated as a carcinogen agent, while it is unknown the real role of HCV in hepatocarcinogenesis. The role played by aflatoxins, ethanol, hemochromatosis, familiarity and sex hormones is still undefined. The clinical presentation of HCC is similar to that of chronic hepatitis and cirrhosis indicating the need of a periodic screening (even 4-6 months) with alpha-fetoprotein determination and abdominal ultrasound scan. Hepatic resection, liver transplantation and percutaneous ethanol injection are the options more frequently chosen for treating patients with HCC.