Introduction: Hepatocellular carcinoma (HCC) is the most common primary tumor of the liver and usually appears as part of liver cirrhosis (LC). Its management in the presence of LC is ideally with orthotopic liver transplantation. Surgical resection is indicated only in the presence of a tumor in a patient with a very good liver function and who for medical reasons cannot be carried to transplantation. Materials and Methods: A descriptive study of a prospective and consecutive series of patients undergoing surgery (resection or liver transplantation) for HCC in a hospital in the city of Medellin was performed, from June 2004 to January 2015. A multivariate analysis was carried out of factors associated with survival during the follow-up. Results: 116 surgical interventions for the management of HCC between June 2004 and January 2015 were performed. The analysis included 107 patients, of which 73% were men. The median age of all patients was 60 years. The factors that showed better survival were: patients undergoing transplantation, the presence of cirrhosis, tumor less than 5 cm in diameter, a unique and well-differentiated tumor; however, none of these factors achieved statistical significance. Conclusion: Both resection and liver transplantation, when well indicated achieve good 5-years of survival in patients with HCC.