After implanting a reservoir in the hepatic artery, we performed intra-arterial chemotherapy with a smaller particle size lipiodol emulsion and examined its therapeutic effect. Subjects were 21 patients with advanced/recurrent hepatocellular carcinoma (HCC). Arterial infusion was performed once every 2 weeks on an outpatient basis using 2 mL lipiodol emulsion with lecithin added as a surface active agent and 10 mg doxorubicin hydrochloride. As of 6 months after the start of treatment, the response rate was 38.1%. Median survival was 17.0 months. Serious adverse events were not noted in any of the subjects;during the course of treatment, catheter occlusion was observed in 2 patients. This therapy allows fewer visits and provides a relatively substantial therapeutic effect while maintaining QOL, so it may serve as an effective treatment for highly advanced/multiple HCC not suited to other treatments.