Hepatocellular carcinoma (HCC) is the fourth leading cause of cancer-related deaths globally, with significant variations in incidence and mortality due to differences in risk factors, healthcare resources, and surveillance practices. Chronic hepatitis B and C, alcohol abuse, metabolic liver diseases, and exposure to dietary toxins like aflatoxins and aristolochic acid are major risk factors for HCC, many of which are preventable. Early detection and surveillance can improve treatment outcomes, but these are underutilized in many regions. Treatment options include local ablation, surgical resection, liver transplantation, and systemic therapies like kinase and immune checkpoint inhibitors. The choice of treatment depends on tumor characteristics, liver function, and patient comorbidities. Preventive measures such as vaccination against HBV and HCV, maintaining a healthy lifestyle, and minimizing aflatoxin exposure are crucial. Molecular subtypes of HCC have been identified, and targeted therapies are being explored. Surveillance strategies, including liver ultrasonography and blood-based biomarkers, are essential for early detection, but their effectiveness varies. Surgical resection and liver transplantation remain the most curative treatments, while locoregional therapies like transarterial chemoembolization (TACE) and radioembolization (TARE) are effective for intermediate-stage HCC. Systemic treatments like sorafenib have shown promise, but further research is needed to optimize treatment approaches.Hepatocellular carcinoma (HCC) is the fourth leading cause of cancer-related deaths globally, with significant variations in incidence and mortality due to differences in risk factors, healthcare resources, and surveillance practices. Chronic hepatitis B and C, alcohol abuse, metabolic liver diseases, and exposure to dietary toxins like aflatoxins and aristolochic acid are major risk factors for HCC, many of which are preventable. Early detection and surveillance can improve treatment outcomes, but these are underutilized in many regions. Treatment options include local ablation, surgical resection, liver transplantation, and systemic therapies like kinase and immune checkpoint inhibitors. The choice of treatment depends on tumor characteristics, liver function, and patient comorbidities. Preventive measures such as vaccination against HBV and HCV, maintaining a healthy lifestyle, and minimizing aflatoxin exposure are crucial. Molecular subtypes of HCC have been identified, and targeted therapies are being explored. Surveillance strategies, including liver ultrasonography and blood-based biomarkers, are essential for early detection, but their effectiveness varies. Surgical resection and liver transplantation remain the most curative treatments, while locoregional therapies like transarterial chemoembolization (TACE) and radioembolization (TARE) are effective for intermediate-stage HCC. Systemic treatments like sorafenib have shown promise, but further research is needed to optimize treatment approaches.