Twenty-eight patients with hepatocellular carcinoma (HCC) of not larger than 5 cm diameter were surgically treated during the 12 years from 1977 to 1988, twenty-five of them since 1983. Half of the patients were admitted for check up because of elevated serum AFP and were high risk subjects. Serum HBsAg were positive in 24 (85.7%). Serum AFP was less than 10 ng/ml in 2 (7.1%) and greater than or equal to 200 ng/ml in 14 (50%). Coexistent liver cirrhosis was found in 21 (75%). Local resection or partial hepatectomy played a major surgical role in small HCC, especially in the presence of cirrhosis and tumor in right liver. The cumulative survival rates for the 28 patients treated by hepatic resection at 1, 2 and 5 years were 60.6, 42.5 and 42.5 percent. The survival rate of patients with tumor size not larger than 3 cm diameter is not better than those with tumor size between 3 cm and 5 cm. The small HCC patients with AFP less than or equal to 200 ng/ml had better survival than those with AFP greater than 200 ng/ml.