The standard strategy in the surgical treatment of hepatocellular carcinoma (HCC) has been outlined based on my experience involving over operated 3,000 cases. My first line operation for HCC is systematic segmentectomy, which carries towards zero mortality and improved survival. Makuuchi′s criteria with bilirubin value and ICG clearance will afford good surgical indication for resection. In living-related liver transplantation, patients with HCC meeting Milan criteria are good candidates. In this review, I will show the surgical treatment options currently available for patients with HCC.