Hepatocellular carcinoma (HCC) is increasing in incidence in the United States and is strongly associated with chronic liver disease and cirrhosis. Surgical therapy with liver transplantation or resection remains the mainstay of curative therapy for patients with HCC. Therapeutic decisions in patients with HCC are complex and are best approached via a multidisciplinary group of liver transplant and hepatobiliary surgeons, oncologists, and hepatologists. In this manuscript, we review the current surgical management of HCC.