Hepatocellular carcinoma (HCC) is the fifth most common cancer in men and ninth most common cancer in women worldwide with 1 million new cases a year. Its incidence is increasing due to improved diagnostic techniques and due to long-term consequences of HBV and HCV infection. HBV infection is the single most important cause of HCC worldwide, the incidence of HCC is higher in countries like China, Taiwan, south Asia and South Africa where the incidence of HBV infection is high than in Western populations. In Taiwan HCC is the most common malignancy among men. In the West, alcohol use and hepatitis C are the major risk factors for HCC; hepatitis B virus (HBV) infection plays a secondary role. In USA, the incidence of HCC also has been rising during the last decades, from 1.4 per 100,000 populations from 1976 to 1980 to 2.4 per 100,000 populations from 1991 to 1995. This increasing tendency will continue over the next 20 years. 2% to 8% annual incidence of HCC is seen in cirrhotic patients. HCC is a growing indication for LTX as the cirrhotic patients with HCC are given a higher priority for LTX.