A variety of therapeutic options have been developed over the past 25 years for the treatment of hepatocellular carcinoma. With advances in antiviral treatment for hepatitis viruses and improvements in surgical techniques, adult-to-adult living-donor liver transplantation has been increasingly carried out in Japan over the past 6 years. The Japanese national health insurance system began to cover adult-to-adult living-donor transplantation from January 2004, which is expected to increase the number of such surgeries. In this review, various therapeutic modalities for the treatment of hepatocellular carcinoma are discussed, with special emphasis on hepatic resection and liver transplantation.