Hepatitis B virus (HBV) reactivation is a well described complication in cancer patitient who receive cytotoxic chemotherapy and may result in varying degree of liver damage. Liver damage due to HBV exacerbation is a 2-stage process. The initial stage occurs during intense cytotoxic therapy and is characterized by enhancing viral replication, as reflected by increases in serum levels of HBV DNA, HBeAg, which presumably result in widespread infection of hepatocytes. The second stage is related to restoration of immune function following withdrawl of cytotoxic therapy, which cause rapid immune-mediated destruction of infected hepatocyte. Clinically, this may lead to hepatitis, hepatic failure, and even death. We report a case of hepatic failure after chemotherapy in patient with HBV-related hepatocelluar carcinoma.