Hepatocellular carcinoma (HCC) is the most common form of liver cancer, accounting for approximately 90% of cases. The primary risk factors for HCC include hepatitis B virus (HBV) and hepatitis C virus (HCV) infections, with non-alcoholic steatohepatitis (NASH) associated with metabolic syndrome or diabetes mellitus becoming an increasingly significant risk factor in Western populations. Molecular pathogenesis of HCC varies based on the underlying etiology, with approximately 25% of HCCs presenting actionable mutations. Diagnosis often relies on non-invasive criteria, but molecular characterization using tissue or liquid biopsies is becoming increasingly important. Advances in treatment have significantly improved outcomes for patients with advanced HCC, with six systemic therapies approved based on phase III trials. New trials are exploring combination therapies, including checkpoint inhibitors and tyrosine kinase inhibitors, which are expected to further enhance management strategies. The role of biomarkers, liquid biopsy, and patient-reported outcomes in future management is also discussed.Hepatocellular carcinoma (HCC) is the most common form of liver cancer, accounting for approximately 90% of cases. The primary risk factors for HCC include hepatitis B virus (HBV) and hepatitis C virus (HCV) infections, with non-alcoholic steatohepatitis (NASH) associated with metabolic syndrome or diabetes mellitus becoming an increasingly significant risk factor in Western populations. Molecular pathogenesis of HCC varies based on the underlying etiology, with approximately 25% of HCCs presenting actionable mutations. Diagnosis often relies on non-invasive criteria, but molecular characterization using tissue or liquid biopsies is becoming increasingly important. Advances in treatment have significantly improved outcomes for patients with advanced HCC, with six systemic therapies approved based on phase III trials. New trials are exploring combination therapies, including checkpoint inhibitors and tyrosine kinase inhibitors, which are expected to further enhance management strategies. The role of biomarkers, liquid biopsy, and patient-reported outcomes in future management is also discussed.