Liver cancer is one of the ten most common cancers in the world with a pronounced geographic variation. The incidence of hepatocellular cancer is low in the Western countries compared to the high prevalence in South Africa, Asia, and the Pacific Islands. Risk factors, early signs and symptoms, and the strategies for early detection are discussed. Primary prevention involves conducting mass immunization for hepatitis B virus in endemic countries along with education programs to improve food hygiene, decreasing alcohol intake, using sterile implements for immunizations and injections, smoking cessation, avoiding unnecessary blood transfusions and screening of blood for transfusions.