Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer and often develops as a complication of liver cirrhosis. Cirrhosis, which involves chronic liver damage and the formation of scar tissue, significantly increases the risk of developing HCC. The main causes of cirrhosis include chronic hepatitis B and C, alcoholic liver disease, and non-alcoholic fatty liver disease (NAFLD). The pathogenesis of HCC in the context of cirrhosis involves complex mechanisms such as regenerative hyperplasia of hepatocytes, inflammatory processes, and oxidative stress, which can cause genetic mutations and malignant transformations. The symptoms of HCC are often vague in the early stages, including fatigue, weight loss, upper abdominal pain, and jaundice. The diagnosis of HCC is usually established through a combination of imaging methods (ultrasound, CT, MRI) and laboratory tests, including the measurement of alpha-fetoprotein (AFP) in the blood. Treatment depends on the stage of the disease and may include surgical removal of the tumor, liver transplantation, local ablations, transarterial chemoembolization, radioembolization, and systemic therapy with targeted drugs. The prognosis of HCC is often poor due to late diagnosis and the presence of underlying cirrhosis, but early detection and advanced therapeutic options can improve outcomes. Regular screening of patients with cirrhosis is crucial for the early detection of HCC and increasing the chances for effective treatment.