OBJECTIVES: The incidence of hepatocellular carcinoma (HCC) in Slovakia is approximately 2,0 and 3,5/100 000 in women and in men. The main objective of this study was to determine the direct medical costs of HCC in Slovakia.METHODS: A retrospective cost of illness analysis of HCC was realized  from the insurance company (IC) perspective. Only patients diagnosed with HCC (C 22.0 according to ICD 10) during 2006 and 2007 were included into this analysis. The costs in local currency were derived from health insurance database. The costs in USD were calculated by average exchange rate in 2006 and 2007. RESULTS: The group of  66 patients (53 men and 13 women) with HCC was analyzed. The average age was 63.4 years (62.5 in men and 67.0 in women). The average duration of monitoring in IC was 7.4 months. The average direct costs were: a, outpatient  – US$618 (12 %), b, inpatient  – US$2554 (50 %), c, examinations   – US$1283 (25 %), including radiology (CT, MRI, PET)- US$380 , nuclear medicine- US$383, biochemistry – US$159, hematology- US$45, pathology – US$133, others – US$183, d, drugs – US$630 (13 %). CONCLUSIONS:The average direct medical costs for patient with HCC in Slovakia were US$5085 per patient. The half of the costs originate from inpatient stay, one quarter is derived from examinations, while costs for drugs and outpatient visits are in the same level (13% and 12% respectively). Costs of HCC are approximately 11 times higher than average yearly medical costs for one inhabitant in Slovakia.