OBJECTIVES: To examine published evidence describing preference-based utility weights for hepatocellular carcinoma (HCC) in order to inform health gains within future economic evaluations in HCC. METHODS: The systematic review of utilities reported in the technology appraisal submission to the National Institute for Health and Clinical Excellence for sorafenib for advanced HCC (TA189) was updated. Studies that reported preference-based utility weights for HCC indexed in the EMBASE.com database were searched for and included. Bibliographic searching of included studies was conducted to retrieve any additional, relevant studies. Health technology assessments (HTA) submissions reporting relevant data were also included. RESULTS: Forty-eight published studies (with 13 primary studies reporting unique data) and two HTA submissions met the inclusion criteria. Four studies directly measured utility or quality of life (QoL) used to derive utility values of patients with HCC; instruments such as the EQ-5D and/or Health Utilities Index Mark Three, or free-standing techniques such as standard gamble or time trade-off (TTO) were employed. The two HTA submissions reported utility weights associated with HCC derived by mapping FACT-HEP clinical trial data to TTO utility values. One cross-study comparison of estimates highlighted that patients without the disease consider the utility associated with HCC to be lower (0.2-0.5) than patients with HCC (0.6-0.8). Utility weights were broadly similar across studies which directly measured utility from patients with HCC or which mapped QoL data from patients with HCC to utility weights, despite differences in study country and utility instrument. Four studies measured QoL using the SF-36 or FACT-G; all demonstrated that scores were lower for the general health perception domain than the other domains. CONCLUSIONS: Consistent with trends documented elsewhere in the literature, utility weights derived from patients with disease were generally higher than those derived from individuals without. There exists little variation in utility score by instrument applied.