Hepatocellular carcinoma is one of the great clinical challenges in medicine. Especially in the Asian-Pacific region, its high prevalence and underlying viral pathogenesis constitute a great economical and social burden. But also in Europe and North America, this disease has become more common, one of the key etiological factors being an increase in ethanol consumption, which in turn has a dramatic impact on liver cell cancer as well as other gastrointestinal malignancies. This publication features up-to-date reviews which present recent epidemiological data from both Asia and Europe, including the role of various risk factors and clinical characteristics. Furthermore, different treatment strategies, including operative and medical treatment, are discussed, with special emphasis placed on the role of gene therapy and transplantation.