Recurrence of hepatocellular carcinoma after liver resection is usually observed in the remnant liver, and includes metachronous multicentric occurrence and intrahepatic metastasis. In stage I and II, disease-free survival rates of clinical stage I patients are significantly better than those of clinical stage II patients, although there are no differences in the disease-free survival rates of patients with advanced disease. Disease-free survival rates in long-term survivors decreased at a constant rate due to metachronous multicentric recurrence. Therefore it is important to follow postoperative patients as long as possible. In the treatment of recurrent tumors, every effort should be made to resect the tumor in the liver. Then, other regional therapies, such as percutaneous ethanol injection therapy, microwave coagulation therapy, and transcatheter arterial chemoembolization, are indicated for patients for whom re-resection is not indicated. To prevent recurrence of hepatocellular carcinoma, it is also important to suppress the hepatic necroinflammatory process due to viral hepatitis.