Most of the causes of hepatocellular carcinoma (HCC) are hepatitis B virus (HBV) or hepatitis C virus (HCV) in Japan. Therefore, strict follow up of chronic liver disease (viral hepatitis and liver cirrhosis) is necessary to diagnose early stage of HCC. Various diagnostic imaging techniques (ultrasonography, computed tomography and magnetic resonance imaging), and tumor markers (AFP, PIVKA-II) are useful for early diagnosis. On the other hand, surgical and medical treatments (transcatheter arterial embolization, chemolipiodolization, percutaneous ethanol injection therapy etc.) have made remarkable progress in these 10 years. Early diagnosis and multidisciplinary treatments are necessary to improve the prognosis of HCC.