The hepatocellular carcinoma (HCC) remains one of the most frequent cancers in Africa. Our objective was to identify the risk factors of the primary liver cancer occurrence among hospitalized patients in the gastro-enterology unit of the university teaching hospital Yalgado Ouédraogo. Methods: We implemented a case-control study and collected data from January 1, 2012 to the December 31, 2015. Controls were recruited among blood donors. Cases were selected among patients visiting the gastroenterology unit of the Yalgado Ouédraogo Hospital. Cases were matched to the controls using age and sex variables. In our multivariate logistic regression model, the outcome variable was the occurrence of the liver cancer. The main independent variable was the chronic carriage of HbsAg. Results: We included 92 cases and 92 controls. The sex ratio was 3. Chronic carriage of HBsAg was diagnosed among 14.13% and 76% of controls and cases, respectively. The anti-HCV Ab test was positive in 15.22% of the cases and 4.35% of the controls. Being 50 years or older, HbsAg chronic carrier, farmer or working in the informal sector or living in a provincial capital were the main statistically significant risk factors to develop primary liver cancer. Conclusion:In Burkina-Faso, liver cancer patients reached out to hospital very late. Our best tools to reduce the incidence and the mortality due to the primary liver cancer include immunizing largely against the HBV infection taking into account the birth dose; and managing adequately the cases of HBV and HCV infections.