Hepatocellular carcinoma (HCC) is the most prevalent primary cancer of the liver accounting for 75% to 85% of primary liver cancers worldwide. It is the sixth most prevalent cancer in the globe and the fourth most prevalent cause of death from cancer, it occurs in males 2 to 3 times higher than in females. Geographical distribution of HCC varies throughout the world being highest in East Asia and sub-Saharan Africa. In general, HCC risk factors include viral infections, cirrhosis, alcohol, non-alcoholic fatty liver disease (NAFLD), aflatoxins, diabetes mellitus and obesity. Egypt has the world's second highest incidence of HCC, which can be ascribed to the elevated prevalence and complications of the hepatitis C virus (HCV). An active surveillance for HCC together with screening programs for HCV and initiation of antiviral therapy with new potent direct acting antivirals (DAAs) at an early stage for patients with chronic HCV infection are the most important steps to reduce the risk of HCC in Egypt.