Qualitative serum alpha‐fetoprotein (AFP) determinations were done on sera from 184 Ugandan patients with hepatocellular carcinoma (HC) and the results correlated with clinical, laboratory, and histopathologic features of the disease. One hundred twenty‐one (66%) were AFP positive. Young patients and those with concomitant hepatitis B antigenemia (HBAg) were AFP positive significantly more frequently than older and HBAg negative patients. There were no differences in AFP frequency between patients with or without antibody to HBAg. There was also a tendency for men and patients with poorly‐differentiated tumors to be positive more frequently than women or patients with well‐differentiated tumors. No correlations with AFP elevation were found for duration of symptoms prior to diagnosis, disease stage, patient survival, standard tests of liver function, elevations of serum proline hydroxylase or serum chorionic gonadotropin, or the presence of concomitant cirrhosis. Sensitive, standardized, quantitative AFP tests should be used in future correlative studies with special emphasis placed on patient age and HBAg.