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We investigated the rates of the treatments and their prognoses in 450 patients with hepatocellular carcinoma (HCC), in order to determine the usefulness of percutaneous microwave coagulation therapy (PMCT) given the present situation of treatment for HCC. Rates of initial treatments were hepatectomy in 31%, percutaneous ethanol injection therapy (PEIT) in 19%, transarterial embolization (TAE) and PEIT in 16%, TAE in 14%, hepatic arterial chemotherapy (HAC) in 7%, PMCT in 7% and others in 6% of cases. The prognosis of PMCT in patients with a single tumor 3 cm in size or less was comparable to that with hepatectomy. Recurrence was found in about 59% of 387 patients who underwent radical treatment initially, and about 96% of these were intrahepatic recurrences. Rates of treatment for intrahepatic recurrence were TAE in 59%, PEIT in 33%, HAC in 31%, PMCT in 24% and hepatectomy in 4% of cases. Indications for use of PMCT were more restricted than for PEIT for reasons of safety. Therefore, the rate of use of PMCT as initial treatment was lower than that of PEIT. On the other hand, the rate of use of PMCT in treatment of recurrence was similar to that of PEIT. PMCT should be used not only as initial treatment but also in the treatment of recurrence, in which HCC is often found at a size 3 cm or less, considering the high incidence of intrahepatic recurrence of HCC as well as reliability of the therapeutic effect and low invasiveness attached to PMCT.