Hepatocellular carcinoma (HCC) is a leading cause of cancer-related death worldwide. Regardless of geography, late clinical presentation with advanced disease and concurrent chronic liver disease confound surgical management. Although epidemiologic and etiologic differences between patients from the East and West exist, surgical management by subtotal hepatectomy is strikingly similar in both technical approach and outcome. A comparative analysis of the surgical management of patients with HCC for the East and West is presented.