Between January 2004 and January 2010, 231 patients with single HCC ≤ 3 cm in diameter received curative treatment using PRFA or SR in our department. Before performing PRFA or SR, a full discussion was made between physician and surgeon. After giving enough information including contents of the discussion between physician and surgeon to patients, patients themselves made decisions whether they received PRFA or SR. In patients with the tumor sites extremely difficult to perform PRFA such as the site directly under the hepatic dome or the heart or with poor visibility of the tumor under ultrasonography owing to extreme obesity or impossibility of breath hold when performing PRFA, SR was performed. And in patients whom high rates of complications were expected as when tumors at the site of hepatic hilar lesion were treated by PRFA, SR was performed. In patients whom informed consent could not be obtained upon SR for the reason such as physical burden, PRFA was performed. Even in patients with poor liver function such as Child-Pugh C, if they wished to treat HCC and there were no ascites, treatment for HCC was performed after fully explaining the risk for treatment. PRFA was administered to 162 patients and 69 patients underwent SR. Written informed consent was obtained from all patients. The ethics committee of our department approved the protocols for PRFA and SR. The present study comprised a retrospective analysis of patient records and all treatments were conducted in an openlabel manner. The primary end point was overall survival and the secondary end point was recurrence free survival.