The incidence of detecting hepatocellular carcinoma in a removed recipient liver after a liver transplant is not rare. The aim of this study was to evaluate the incidental hepatocellular carcinoma at our center. We retrospectively analyzed outcomes of 6 patients with incidental hepatocellular carcinoma among 238 patients with liver transplant who had been operated on between September 2001 and June 2008. The proportion of incidental hepatocellular carcinoma was 2.5 %. The rate of incidental hepatocellular carcinoma among all hepatocellular carcinoma patients was 14% (36 versus 6). There were 3 children and 3 adults (mean age, 22.6 ± 24.5 years; age range, 1-49 years). Two of these patients were 1 year old. The alpha-fetoprotein level was within the normal range in all patients. Preoperative imaging studies demonstrated regenerative or dysplastic nodules or no specific lesion in all patients. One of the grafts was from a deceased donor, and 5 were from living-related donors. We encountered no complications after the transplants. Pathology findings showed a mean tumor size of 0.94 ± 0.2 cm (range, 0.5-1.2 cm) and multiplicity in 1 patient (16.6%). One patient with multiple tumors had microvascular invasion. According to the TNM staging system, 5 patients had stage-I, and the remaining patient had stage-II, carcinoma. There were no recurrences of hepatocellular carcinoma, and no mortality occurred during a mean follow-up of 33 ± 16.5 months (range 3-49 months). In conclusion, the incidence of hepatocellular carcinoma in patients with cirrhosis who have undergone a liver transplant is similar to that reported in other studies. Incidentally found hepatocellular carcinomas showed less invasive pathology features and better prognoses than did preoperatively detected hepatocellular carcinomas.