Hepatocellular carcinoma (HCC) have relatively well known causative factors such as chronic hepatitis B, chronic hepatitis C, alcoholic liver disease, Non-alcoholic fatty liver disease (NAFLD), liver cirrhosis and so on. Recently, interesting reports that HCC in the absence of cirrhosis or other chronic liver disease and HCC associated with NAFLD and metabolic syndrome are increasing in USA. So far, there is no report about these issues in Korea. We present a 65 yearold obesity male who had no preceding chronic liver disease history. He was diagnosed as primary HCC and the mass was removed completely. However, HCC recurred shortly after operation. Multiple recurred HCC were treated with transcatheter arterial chemoembolization. (J Liver Cancer 2015;15:112-117)