The purpose of this preliminary study was to evaluate whether laser-induced interstitial thermotherapy (LITT) may be used for palliative treatment of localized hepatocellular carcinomas (HCC). We applied LITT to two patients suffering from unresectable localized hepatocellular carcinomas of different sizes (2.5 and 4 cm). LITT was performed with an Nd:YAG laser (1,064 nm) at 5 W laser power (15-20 minutes). Thermometry during LITT was performed by MRI using a temperature-sensitive T1-weighted fast low-angle shot (FLASH) sequence. Follow-up for local tumor control was performed by MRI and ultrasound. LITT was well tolerated and no adverse events occurred during or after LITT; no secondary liver lesions were seen in the follow-up (11 or 12 months, respectively). Only minimal tumor growth was observed in the larger HCC (from 4 to 5 cm), whereas the smaller HCC remained unchanged in size during 11 months of follow-up. We conclude that LITT might be an effective minimally invasive palliative treatment option for patients with small unresectable HCC.