Whether the prognosis of hepatocellular carcinoma in young patients is different from elderly patients is still controversial. Previous reports revealed that most of the young hepatocellular carcinoma patients have hepatitis B viral infection, larger tumor and more advanced stage than elderly patients, and these features not just young age are related with poor survival. We experienced a case of stage IVA hepatocellular carcinoma suspected to be related with autoimmune hepatitis in a 28-year-old man. Even though 3 times of transarterial chemoembolization and best supportive care were given, he died 7 months after diagnosis.