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Hepatocellular carcinoma (HCC) during pregnancy is very rare with poor prognosis. We report a case of a HCC in a 33-year-old, pregnant female with an otherwise normal liver and no risk factors, diagnosed by routine prenatal ultrasound scan and elevated alpha-feto protein levels. She underwent a synchronous caesarean section and liver resection at 30 weeks of gestation with good perioperative outcome and no recurrent disease at 1-year follow-up. This case report discusses the clinical presentations, diagnostic and therapeutic strategies and literature review of this rare presentation.