A comparison of the gross pattern of hepatocellular carcinoma (HCC) was made using autopsy material from Japan (378 cases), the United States (90 cases), and South Africa (61 cases). The tumor could be placed in three major gross patterns only if subcategories of each were created. The common major patterns were expanding, spreading, and multifocal. There was a relationship of gross pattern to the presence or absence of prior liver disease, and there were differences in frequency of occurrence of the various gross types in the material from the above-mentioned countries.