Hepatocellular carcinoma (HCC) stands as the most prevalent type of primary liver cancer, with projections indicating over one million new cases by 2025. It ranks as the sixth most frequently diagnosed cancer worldwide and is the fourth leading cause of cancer-related mortality on a global scale. The underlying causes of HCC vary by region and are usually linked to chronic liver disease, with fewer instances arising in healthy liver tissue. Hepatitis B and C infections remain the predominant contributors to HCC onset. However, in Western countries, non-alcoholic steatohepatitis—often associated with metabolic syndrome or type 2 diabetes—is becoming increasingly significant. The burden of HCC, in terms of both incidence and death rates, is heaviest in East Asia and Sub-Saharan Africa. This chapter focuses on the epidemiology of HCC, particularly in low- and middle-income regions.