【Abstract】 Objective To compare the therapeutic effect of percutaneous radiofrequency ablation and laparoscopic liver resection in treatment of small hepatocellular carcinoma. Methods 126 patients with small hepatocellular carcinoma were selected. According to the different treatment methods, the patients were divided into laparoscopic liver resection group (61 cases) and percutaneous radiofrequency ablation group (65 cases). The outcome was observed. Results The surgery of all patients were successfully completed. There were no laparotomy in the laparoscopic liver resection group and there were complete ablation in the percutaneous radiofrequency ablation group. The pain, pulmonary infection, bleeding, nausea, vomiting and other complications (83%) in the percutaneous radiofrequency ablation group were significantly less than that of the laparoscopic liver resection group (267%) (P＜005). The serum ALT and AST after operation in the percutaneous radiofrequency ablation group and the laparoscopic liver resection group were significantly lower than that before operation (P＜005). The serum levels of ALT and AST in the percutaneous radiofrequency ablation group were significantly lower than those in the laparoscopic liver resection group (P＜005). The survival time and tumor free survival time of the percutaneous radiofrequency ablation group were significantly higher than that in the laparoscopic liver resection group(P＜005). Conclusion Compare to laparoscopic liver resection, percutaneous radiofrequency ablation application in treatment of small hepatocellular carcinoma has high success rate, which can promote the recovery of liver function, reduce the incidence of postoperative complications and extend the survival time of patients.