Hepatocellular carcinoma (HCC) is the most common malignancy of the liver. Incidence varies worldwide; however, the high mortality rate of HCC is consistent globally. HCC typically arises in the setting of chronic liver disease and cirrhosis. Screening of high-risk patients with abdominal ultrasound and serum alpha fetal protein levels is indicated. Patients often present with signs and symptoms of varying degrees of liver dysfunction. Management is complex and requires multidisciplinary evaluation of a patient’s functional status, liver function, and tumor characteristics. Surgery, either liver resection or transplantation, is curative-intent treatment for this disease. Adjunct nonsurgical therapies are often employed to improve resectability or manage unresectable disease. Resection and transplantation are technically challenging and have potential for life-threatening complications, especially if performed in suboptimal patient populations. Postoperative surveillance with cross-sectional imaging and AFP levels is performed every 6 months for 2 years, and then annually. However, even with resection and adjuvant therapy, recurrence rates in HCC unfortunately remain high and prognosis remains poor.