Abstract: Objective To compare the clinical effect of percutaneous radiofrequency ablation(PRFA) for hepatocellular carcinoma in elderly patients and in non-elderly patients. Methods We reviewed the clinical data of 77 HCC patients undergone PRFA from March, 2004 to August, 2007.Patients were categorized into two groups by their age: the elderly group (n=31), aged 60 and above, and the non-elderly group (n=46), younger than 60 years old. Survival time, treatment-related complications were compared between the two groups. Factors that may influence the outcome were also determined using a multivariate analysis with Cox regress model. Results The tumor complete elimination rate was similar (87.1% vs 82.6%,P=0.832). The 1, 2 and 3 year recurrence rates were 44.4％，59.8％，71.3％respectively in the elderly group, and were 56.4％，70.7％，78.1％respectively in the non-elderly group. There was no significant difference between the two groups (P=0.464). The 1,2 and 3 year survival rates for the elderly group and the non-elderly group were 89.6％,63.8％，35.9％vs 78.9％，46.6％，20.1％, respectively (P=0.114).Regarding the rate of treatment related complication, no significant difference was found between the two groups (29.0％vs 26.1％, P=0.776). Recurrence tumor, non-solitary tumor and recurrence after PRFA except tumor size and age were found to be the prognostic factors. Conclusion PRFA had the advantage of less invasiveness and the survival rate in the elderly patients was as comparable as that in the non-elderly patients. PRFA may be more suitable to elderly patients as one of the treatment modality for hepatocellular carcinoma, especially to those who with recurrence tumor.