The distribution of blood vessels in human hepatocellular carcinoma was studied with the anti-a-smooth muscle actin monoclonal antibody by light and electron microscopy, and with morphometric analysis. a-Smooth muscle actin-positive arterioles were never observed in lobules or pseudolobules of non-cancerous areas, but were frequently seen within hepatocellular carcinomas. Morphometric analysis revealed that most of these arterioles measured between 10 and 25 microns in diameter. The morphology of intratumoural arterioles differed considerably from that of conventional arteries in the portal tracts of the non-cancerous area. The presence of abundant intratumoural arterioles can explain the angiographic hypervascularity of hepatocellular carcinoma and provides a pathological basis for its susceptibility to hypoxia and for arterial embolization as a therapeutic strategy.