The authors report their experience of the diagnosis of hepatocellular carcinoma using needle aspiration cytology over a four year period (1989-1992). In 116 of the 119 patients presenting with histologically proven hepatocellular carcinoma, the diagnosis was previously established by cytology. This method has a 97% sensitivity. Also, in forty patients without hepatocellular carcinoma, previous cytology did not detect any carcinomatous cells and therefore recorded a 100% specificity. Thus, cytologic diagnosis of hepatocellular carcinoma is possible. In countries with limited resources in which this carcinoma is widespread, needle aspiration cytology needs to be well known and used.