Early diagnosis of hepatocellular carcinoma (HCC) is essential in improving survival, creating a need for new markers in the early diagnosis and surveillance of HCC. This study aims to investigate the prediction of the GALAD score, which consists of gender, age, AFP, AFP-L3, and DCP, in the diagnosis of HCC in cirrhotic patients with normal AFP levels. GALAD scores were determined in 100 patients with cirrhosis and normal AFP in a tertiary center. The role of the GALAD score in the surveillance of HCC was investigated prospectively. 100 cirrhotic patients (59 male, mean age 60.4 ± 13.6 years) participated. GALAD score was higher in cases with HCC (GALAD = -0.66 in cases with HCC, and - 3.10 in cases without HCC, p < 0.001). The cut-off value of the GALAD score in the diagnosis of HCC was found to be -1.93 according to ROC analysis (AUC of 0.798, 95% CI: 70.5-89.1, sensitivity = 71%, specificity = 71%). In regression analysis, the risk of developing HCC was 3.4 times higher in patients with a GALAD score ≥ -1.93. The GALAD score is an important marker for the surveillance of HCC in cirrhotic patients with normal AFP.