Growing evidence indicates that the aberrant expression of microRNAs (miRNAs) contributes to tumor development; however, the function of miRNAs in human hepatocellular carcinoma (HCC) remains largely undefined. In this study, we report that microRNA-422a (miR-422a) is significantly down-regulated in HCC tumor samples and cell lines compared with normal controls, and its expression level is negatively correlated with pathological grading, recurrence, and metastasis. The restoration of miR-422a expression in HCC tumor cells significantly inhibited cell proliferation and migration in vitro. At the same time, the overexpression of miR-422a in HCC tumor cells significantly inhibits tumor growth and liver metastasis in xenograft tumor models. A mechanistic study identified three genes, forkhead box G1 (FOXG1), FOXQ1, and FOXE1, as miR-422a targets in the regulation of HCC development. We also investigated the function of the three targets themselves in HCC tumorigenesis using RNAi manipulation and demonstrated that the knockdown of these targets led to significant inhibition of tumor cell proliferation and migration both in vitro and in vivo. More interestingly, a potential miR-422a promoter region was identified. Both the promoter activity and miR-422a expression were negatively regulated by the three targets, indicating that a double-negative feedback loop exists between miR-422a and its targets. Moreover, we explored the therapeutic potential of miR-422a in HCC treatment and found that the therapeutic delivery of miR-422a significantly inhibited tumor development in a xenograft tumor model and a diethylnitrosamine-induced primary HCC model. Conclusion: Our findings show the critical roles of miR-422a and its targets-FOXG1, FOXQ1, and FOXE1-in the regulation of HCC development and provide new potential candidates for HCC therapy. (HEPATOLOGY 2015;61:561-573) H epatocellular carcinoma (HCC) is the fifth most common malignancy and the second leading cause of cancer-related mortality worldwide, resulting in almost 0.7 million deaths each year. Currently, the therapeutic options are limited largely to liver transplantation and surgical resection.HCC mortality has decreased with advances in surgical resection; however, the long-term prognosis of this treatment is still unsatisfactory. The 5-year survival rate is less than 30% in HCC patients after surgical resection, mainly because of the high recurrence and metastasis rate.1 A strong need for more effectiveAbbreviations: 3 0 UTR, 3 terminal untranslated regions; DEN, diethylnitrosamine; FOXE1, forkhead box E1; FOXG1, forkhead box G1; FOXQ1, forkhead box Q1; HCC, hepatocellular carcinoma; MiR-422A, microRNA-422a; NAT, noncancerous adjacent tissues; qPCR, real-time quantitative PCR.From the