Hepatocellular carcinoma (HCC) is the third commonest cancer in Hong Kong. Up to 80% of patients have inoperable tumour at presentation, either because of underlying cirrhosis or advanced stage of the disease. The present report described a case of orthotopic liver transplantation (OLT) for HCC. Prognostic factors for survival and selection criteria for liver transplantation are discussed. Early referral of selected patients with HCC to a transplant centre can offer a hope of cure. The best candidate for OLT is a young patient with an asymptomatic small HCC in a cirrhotic liver.