Our intent was to evaluate whether laparoscopic radiofrequency ablation for patients with unresectable hepatocellular carcinoma and a high degree of liver damage has a role to play in the management of the disease. Laparoscopic and hand-assisted laparoscopic radiofrequency ablations were performed on five patients and the short-range outcome and complications of these patients were evaluated. The evaluation of the primary liver tumor by the radiofrequency ablation was carried out by computed tomography on the seventh day after surgery. Three patients underwent laparoscopic radiofrequency ablation, and the other two patients underwent hand-assisted laparoscopic radiofrequency ablation. The Child-Pugh status of all tumors was B status, and one patient had complications due to postoperative ascites. Laparoscopic and hand-assisted laparoscopic radiofrequency ablation with a cooled-tip electrode needle was found to be a safe and effective local treatment of hepatic focal lesions.