The diagnostic role of arteriography in the evaluation of hepatocellular carcinoma is pointed out. In the identification of large lesions angiography achieves a sensitivity of 100%. However, when evaluating small lesions (under 5 or 3 cm in diameter), the sensitivity is reported to be 82-89%. To increase the sensitivity, different special techniques have been developed which require angiographic placement of a catheter. These include CT arteriography, CT arterial portography and CT after intraarterial injection of iodized oil. Particularly with the two latter techniques, the sensitivity in identification of small hepatocellular carcinoma reaches a value of 91-95%. Angiography can also be proposed for the characterization of neoplastic lesions in cirrhotic livers. Its specificity is 72% in the differential diagnosis of hepatocellular carcinoma and adenomatous hyperplastic nodules. Small grade I hepatocellular carcinoma can simulate this benign lesion at angiography, as well as at histology. Finally, angiography may still play a role in the preoperative staging of hepatocellular carcinoma both for the diagnosis of satellite lesions and for the identification of vascular invasion.