Background: Radiofrequency coagulation (RFC) is being promoted as a novel technique with a low morbidity rate in the treatment of liver tumours. The purpose of this study was to assess critically the complication rates of RFC in centres with both large and limited initial experience, and to establish causes and possible means of prevention and treatment. The morbidity and mortality of RFC, while low, is higher than previously assumed. With adequate knowledge, many complications are preventable.