During the past decade, the diagnostic technologies concerning the hepatocellular carcinoma have been enriched by the vascular doppler ultrasound, the ultrasound echo-enhancing agents and the magnetic resonance tomography. The therapeutic possibilities have been augmented by the percutaneous ethanol instillation therapy, the combination of local therapies with transcatheter arterial embolisation and the more effective after-treatment after transplantation and segment resection. The use of the respective treatment modalities depends on the tumor constellation, the functional liver reserve, the patients general condition and the risk/benefit ratio of the treatment. The quality of life should be optimized because of the poor tumor prognosis. As there have been no real advances in the treatment of hepatocellular carcinoma to date, the prevention and early diagnosis of the tumor in high risk populations is of utmost importance.