Early-stage hepatocellular carcinoma refers to small hepatocellular carcinoma (SHCC) with a diameter of ≤2 cm, characterized by high differentiation, blurred borders, and lack of or incomplete fibrous envelope. Its cell morphology is characterized by small cell volume, deeply stained nuclei, and increased nucleoplasmic ratio. Imaging examination shows that early hepatocellular carcinoma is mostly isointense or slightly hypointense in CT plain scan and may have no obvious enhancing or mild enhancement in arterial phase of enhancement scan. In MRI examination, early hepatocellular carcinoma is mostly with high signal or is osignal in T1WI, and isosignal or slightly high signal in T2WI, and the DWI sequences may show high signal. In ultrasonography, early-stage hepatocellular carcinoma mostly has dual blood supply (portal vein and hepatic artery), which is easy to be misdiagnosed or missed. Diagnosis of early hepatocellular carcinoma needs to be combined with imaging manifestations and pathologic examination to differentiate it from HGDN.