Hepatocellular carcinoma (HCC) is an aggressive primary liver cancer that arises in a background of hepatic cirrhosis. In the United States, HCC has been increasing due to an increasing prevalence of the Hepatitis C virus which causes cirrhosis. Curative treatment of HCC is indicated when tumors are small and may include surgical resection, liver transplant, or radiofrequency ablation. Locoregional treatment includes transarterial chemoembolization and transarterial radioembolization which can be used as eithera an adjunct to surgical care or as primary therapy. This review article will examine the initial surveillance of patients at risk for HCC, the current guidelines related to diagnosis and staging of HCC, and will conclude with a review of best practices related to the treatment of HCC.