There remains a lack of clear consensus regarding the optimal time to discontinue post-liver transplant (LT) surveillance for patients transplanted with a diagnosis of hepatocellular carcinoma (HCC). Recurrence of HCC most commonly occurs in an early to late pattern, and less commonly after 5 years post-LT. Multiple risk prediction models have been offered to evaluate the likelihood of posttransplant HCC. Liver transplant centers should adopt a risk prediction model and stratify patients into low/moderate versus high-risk for recurrence. Post-liver transplant surveillance for hepatocellular carcinoma can stop if there is absence of HCC recurrence after 5 years in low-to-moderate risk patients. Patients deemed to be at elevated risk should continue surveillance imaging and alpha fetoprotein (AFP) beyond 5 years; however, it is reasonable to consider limiting this to annual surveillance or ultrasound to minimize harm associated with over testing.