A clinical staging system for hepatocellular carcinoma (HCC) is usually developed based on the primary liver tumor, the extent of tumor involvement, and the impact of the tumor on prognosis. The staging system can be used for prognostic stratification and describing the severity of malignancy in individuals. Accurate clinical staging of HCC is not only helpful for the formulation of a reasonable treatment procedure and prognostic assessment by clinicians but also for the design of a clinical study, such as subject selection and grouping. There have been various clinical staging systems of HCC. Nearly all of these systems were developed based on HCC cohorts and clinical practice in a specific country or region. By 2018, approximately 20 staging systems of HCC have been proposed worldwide. The multiplicity of the staging systems highlights the fact that a single widely accepted staging system is still lacking and that HCC staging is extremely complicated.