Although there is no universally accepted staging system, the Barcelona Clinic Liver Cancer (BCLC) has been the most widely validated and has been incorporated into several guidelines. However, advances in therapeutic options and a better understanding of tumour biology have prompted efforts to define more nuanced staging systems facilitating more personalized prognostic and treatment approaches. In this chapter, we will present data for (and against) the use of the BCLC as the preferred staging system for hepatocellular carcinoma as well as alternative staging options.