A clinicopathologic analysis of 93 hepatectomies of < 3 cm small hepatocellular carcinoma (small-HCC) over the last ten years was made, which accounted for 8.5% in 1096 resected HCC during the same period. Serum AFP levels of > or = 400 micrograms/L in patients with small-HCC accounted for 40.3%. The rate of capsule formation was 58.1%, and the incidences of tumor direct invasion, cancer thrombus as well as tumor satellites were 33.3%, 28% and 3.2%, respectively. The 5-year postoperative survival rate of patients with small-HCC was 77.9%. It is proposed that the essential features of < 3 cm small-HCC are: (1) expanding growth pattern and capsule formation in majority of the cases; (2) the lesions are limited, seldom occurring long-distance (> 2 cm) invasion; (3) the incidence of cancer thrombus and satellites are lower; and (4) the majority of < 3 cm small-HCC are of diploid DNA content, showing a relatively slow growth. It is considered that < 3 cm small- HCC basically reflects the pathobiologic features of early HCC, and is an important opportunity of achieving radical therapeutic effect after the resection.