Early diagnosis and treatment of hepatocellular carcinoma is still an important part of improving the efficacy, and early hepatectomy is the most effective radical means of hepatocellular carcinoma treatment at present. Early hepatocellular carcinoma is mostly small hepatocellular carcinoma, and those who can be resected in one stage should undergo radical resection in time. Irregular local radical resection of liver tumor can maximize the preservation of normal liver tissues and facilitate postoperative recovery, thus significantly improving the resection rate of liver cancer and reducing the operative mortality rate, and its long-term efficacy is similar to that of regular resection. At present, the indications for surgical procedures have been expanded, and there is still a need to continue to accumulate experience in the treatment of hepatic resection for hepatocellular carcinoma confined to the portal vein or bile duct with intra-biliary thrombosis or combined with severe portal hypertension. For hepatocellular carcinoma with large tumor and multiple nodes, the envelope is often incomplete and there are intrahepatic dissemination and portal vein thrombus, so it is difficult to completely remove the tumor by palliative resection, and the postoperative stimulation of hepatic resection may accelerate the dissemination and metastasis of residual carcinoma, so non-resectional palliative surgical treatment or non-surgical treatment (hepatic artery chemoembolization is preferred) can be used. In order to reduce recurrence after resection, the principle of tumor-free must be emphasized intraoperatively to reduce medically-derived spread, and every effort should be made to ensure adequate cutting edge and complete removal of tumor and cancer thrombus. After radical resection of hepatocellular carcinoma, all patients should be reviewed regularly and adopt comprehensive interventional treatment to remove residual cancer or prevent recurrence, which is an important means to improve the efficacy of hepatocellular carcinoma. For patients with palliative resection, postoperative active anti-tumor therapy should be given in a timely manner to control the growth of tumor and further prolong the survival time of patients with tumor. For patients who cannot be resected, it is appropriate to actively adopt comprehensive treatment with various therapeutic methods to obtain second-stage resection or improve life quality and prolong life after tumor shrinkage. For recurrent hepatocellular carcinoma after resection, those who have the conditions should actively strive for re-operative resection, while patients with deeper lesions, multiple lesions and poor liver function can adopt non-operative treatment. Liver transplantation is mainly suitable for patients with small hepatocellular carcinoma combined with severe cirrhosis, and recent data suggest that its long-term efficacy is better than that of hepatectomy. However, patients with venous cancer thrombosis, intrahepatic dissemination or extrahepatic organ metastasis should be contraindicated. In China, the indications for liver transplantation for hepatocellular carcinoma are further expanded on the basis of the internationally recognized Milan criteria and UCSF criteria, and multiple selection criteria are proposed, which are yet to be agreed on the basis of evidence-based medicine.