Hepatocellular carcinoma (HCC) is a primary tumor of the liver, which usually develops in the setting of cirrhosis and less frequently of precirrhotic chronic liver injury. The main etiologies of cirrhosis and HCC are infections with HCV or HBV, alcohol and metabolic syndrome. To the diagnostic panel of HCC belong conventional ultrasonography, contrast imaging techniques, serological markers and cytological/histopathological examination. In non-surveyed cirrhotic population HCC is most frequently detected in advanced stages, disqualifying patients from radical therapy. The crucial point of oncological ultrasonographic surveillance is detection and diagnostic confirmation of early HCC. In this review we presented diagnostic problems regarding early and advanced stages of HCC.