Normal alkaline phosphatase cannot rule out liver cancer, and the diagnosis of liver cancer does not depend on the value of alkaline phosphatase. Serum alkaline phosphatase is mainly derived from the liver and bone. Elevated alkaline phosphatase is common in patients with biliary obstruction, hepatitis, cirrhosis, and fibrous bone disease. Alkaline phosphatase may be normal or elevated in patients with hepatocellular carcinoma. Therefore, alkaline phosphatase cannot be used as a diagnostic indicator of hepatocellular carcinoma, and hepatocellular carcinoma cannot be ruled out by normal alkaline phosphatase. Diagnosis of hepatocellular carcinoma needs to be assisted by medical history, alpha-fetoprotein, ultrasound and CT and other imaging tests. Abnormal elevation of alpha-fetoprotein is a specific tumor marker for liver cancer. Abnormal elevation of alpha-fetoprotein coupled with ultrasound, CT and other imaging tests to detect space-occupying lesions in the liver that are rich in blood supply can help to diagnose liver cancer. Normal alkaline phosphatase cannot exclude hepatocellular carcinoma, and patients should go to the hospital in time to improve the relevant examinations in order to clarify whether they have hepatocellular carcinoma.