The article reviews the epidemiology and management of hepatocellular carcinoma (HCC), focusing on emerging data on risk factors, surveillance, and treatment advancements. HCC incidence and mortality are increasing in North America and Europe but declining in high-risk regions like Japan and parts of China. Key risk factors include chronic hepatitis C and B, heavy alcohol consumption, diabetes, and non-alcoholic fatty liver disease (NAFLD). Direct-acting antivirals (DAAs) have significantly reduced HCC risk in patients with chronic hepatitis C, while antiviral therapy has reduced HCC risk in those with chronic hepatitis B. NAFLD is a leading cause of HCC in the United States, with higher prevalence among Hispanics. The article discusses the role of tumor biopsy in patient selection for therapy, the importance of staging systems, and the effectiveness of various treatments, including resection, radiofrequency ablation, chemoembolization, and sorafenib. It also highlights the potential of combination therapies and immune checkpoint inhibitors in advanced HCC.The article reviews the epidemiology and management of hepatocellular carcinoma (HCC), focusing on emerging data on risk factors, surveillance, and treatment advancements. HCC incidence and mortality are increasing in North America and Europe but declining in high-risk regions like Japan and parts of China. Key risk factors include chronic hepatitis C and B, heavy alcohol consumption, diabetes, and non-alcoholic fatty liver disease (NAFLD). Direct-acting antivirals (DAAs) have significantly reduced HCC risk in patients with chronic hepatitis C, while antiviral therapy has reduced HCC risk in those with chronic hepatitis B. NAFLD is a leading cause of HCC in the United States, with higher prevalence among Hispanics. The article discusses the role of tumor biopsy in patient selection for therapy, the importance of staging systems, and the effectiveness of various treatments, including resection, radiofrequency ablation, chemoembolization, and sorafenib. It also highlights the potential of combination therapies and immune checkpoint inhibitors in advanced HCC.