Systematic screening for hepatocellular carcinoma (HCC) in cirrhotic patients by alpha-fetoprotein and ultrasound permits the detection of small asymptomatic tumors. Owing to the small tumor size, more liver resections can now be performed than in the past. These resections are performed in a more economical way in terms of loss of functional parenchyma and in a more appropriate manner with regard to carcinology: surgical techniques of liver segmentectomy and use of intraoperative echography are mandatory. Favorable long-term results obtained in Eastern countries by resecting such lesions are encouraging but remain to be confirmed in the Western hemisphere.