The serum level of alpha-fetoprotein (AFP) is a marker for primary liver tumors. To evaluate the relationship between the serum level of AFP and the positivity of liver tissue for this marker, specimens of liver were obtained at autopsy from patients with hepatocellular carcinoma (HCC). Tissues were fixed with formalin or Kryofix and immunostained for AFP. Serum AFP titer at autopsy was positively correlated with AFP staining in tissue fixed by Kryofix and stained with monoclonal antibody against AFP. The correlation was significant for plasma levels of AFP above 5,000 ng/ml. Results suggest that elevated serum AFP levels are an indicator of the progression of HCC.