Long nodules in the liver with elevated alpha-fetoprotein (AFP) are likely to be hepatocellular carcinoma, but the diagnosis of hepatocellular carcinoma cannot be confirmed on the basis of elevated AFP. The diagnostic criteria for liver cancer are AFP ≥400ng/ml, typical imaging manifestations of liver cancer, or positive pathologic biopsy. The presence of liver nodules with elevated AFP is more likely to be considered hepatocellular carcinoma. Liver nodules may also be benign nodules. Factors causing elevated alpha-fetoprotein, besides hepatocellular carcinoma, can also lead to elevated alpha-fetoprotein in pregnant women, certain embryonic malignant tumors, and chronic active hepatitis. Thus, this liver nodule is not necessarily liver cancer. Patients with liver nodules and elevated alpha-fetoprotein need to consult a doctor in time, complete the relevant examinations, make a clear diagnosis and then actively treat the disease.