Objective: To determine the diagnostic accuracy of USG in detecting hepatocellular carcinoma. Methodology: A total of 70 patients with liver cirrhosis with mass and age 18-60 years of either gender were included. Nodular lesion <3 cm in size, non-specific vascular profile, poor visualization and FNA / biopsy can cause complications were excluded. All the patients were then underwent first ultrasound and then histopathology. The ultrasonography findings were recorded presence or absence of HCC and correlated with CT scan findings. Results: In USG positive patients, 31(44.28%) (88.8%)True Negative had no hepatocellular carcinoma on histopathology (p=0.0001). Overall sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of ultrasound in detecting hepatocellular carcinoma keeping histopathology as gold standard was 88.57%, 91.43%, 91.18%, 88.89% and 90.0% respectively. Conclusion: This study concluded that grey scale ultrasound along with Doppler ultrasound  is a simple, non-invasive, economical, readily available imaging modality with high sensitivity and accuracy in diagnosing hepatocellular carcinoma.