Overexpression of cyclooxygenase 2 (COX-2) is associated with the development of a number of human cancers including hepatocellular carcinoma (HCC). In addition, NS398, a selective COX-2 inhibitor, has been found to inhibit the growth of COX-2 expressing HCC cell lines. However, the mechanism of this effect remains unclear. Here, we report that NS398 inhibits the growth of the Hep 3B human HCC cell line and that inhibition results from the induction of apoptosis with no evidence of cell cycle arrest. We also show that the extent of apoptosis is greatly influenced by culture conditions. The NS398-induced apoptosis in Hep 3B cells is caspase-independent. Our data point to the feasibility of preventing HCC by means of COX-2 inhibitors, and show that the environment influences the cytotoxic effect of NS398 on cancer cells.