Hepatocellular carcinoma is the commonest primary liver cancer and its incidence is gradually rising. Is the second cause of cancer mortality, mainly appearing in cirrhosis patients. Chronic infection with hepatitis C and B viruses, alcohol and aflatoxins are the commoner causes. Nowadays, liver fatty disease is becoming an important cause, mainly in developed countries. On risky population, ultrasound screening is essential for early diagnosis of hepatocellular carcinoma. Diagnostic basics are imaging tests and, if required, histopathology. According to clinical variables (tumor associated symptoms and comorbidities), and liver function, the most suitable treatment strategy is established.