Aim: The aim of this study is to prove or disprove the superiority of surgical resections over radiofrequency ablation (RFA) with respect to efficacy and safety. Methods: The study was conducted in Zagazig University Hospitals, which included 40 patients with hepatocellular carcinoma (HCC) during the period from November 2011 to December 2014, using either liver resection or RFA. Results: Hepatic resection was done in 20 patients (13 males, 7 females). Interventional RFA was done in 20 patients (12 males, 8 females). There was no in-hospital mortality after resection. One-and two-year survival rates were 85% and 70% respectively. There was no in-hospital mortality after RFA. One-and two-year survival rates were 80% and 65% respectively. Conclusion: Surgical resection is preferred over RFA in HCC-liver cirrhosis Child A patients with tumor sizes ≥ 3 cm. HCC-liver cirrhosis Child A patients with masses < 3 cm have almost the same results with both surgery and RFA. But in special cases such as central position lesions, RFA is preferred over resection. Also the decision for management may be changed according to patients well. Surgical resection 1-and 2-year survival rates were better than those treated with RFA.