Small hepatoma is defined a s hepatocellular carcinoma less than 3 cm in maximum diameter and fewer than 3 in number. To assess the ability of ultrasound to detect small hepatomas, a prospective study was done in a group of patients with HBsAg-positive chronic hepatitis and liver cirrhosis. Herein, we present 4 hypoechoic small hepatomas detected on ultrasound and emphasized the role of real-time ultrasonography as a practical test form monitoring hepatoma high-risk subjects.