OBJECTIVES: This analysis aimed to verify how Hepatocellular Carcinoma (HCC) management is carried out in Italy and to point out the organizational key variables useful for an economic assessment, considering that Italy is among the European States with the highest incidence of HCC according to recent published data and that HCC is the final and highest cost health state along the natural history of liver diseases. METHODS: A questionnaire was set up jointly by clinicians (hepatologists and infectivologists), pharmacoeconomists and HTA experts, and submitted to 9 centers in order to collect epidemiology and management data. The survey consisted of a series of questions regarding HCC patients: gender and age, HCC etiology, BCLC (Barcelona Clinic Liver Cancer) staging at diagnosis, current treatments, hospitalization regimens, number and description of diagnostic/outpatient procedures, other relevant concurrent pathologies. The survey was administered to patients in four Italian centers of excellence for liver diseases with well-established experience in treating HCC patients. RESULTS: 596 questionnaires were collected, the majority of which regarding male patients (79%), with a mean age of 67. Etiology proved to be mainly HCV-related (56%) and most patients underwent full hospitalization (81%) with a mean duration of 16.5 days, with a wide variability among centers, concerning both diagnostic procedures (CT, MRI, ecography…) and treatments (surgery, liver transplantation, drugs…). CONCLUSIONS: The collected data show a major heterogeneity, linked to the different etiology and epidemiology of the disease along the peninsula, well characterized by a number of published studies, but prove to be very helpful in describing the current situation regarding HCC in Italy. This descriptive analysis will be useful to set up a prospective study with the aim to implement an economic model able to compare different treatments and diagnostic procedures, and including organizational aspects in accordance to a cluster-randomized logic.