Purpose : Transcatheter arterial chemoembolization (TACE) and subsequent percutaneous ethanl injection (PEI)was attempted in 8 patients with 9 hepatocellular carcinomas (HCCs) for complete tumor necrosis of HCCs less than5cm in greatest diameter. Materials and methods : PEI was performend with 2-8 ml of absolute (99.9%) ethanol twoweeks after TACE under CT or ultrasound guidance. For each patient PEI was done twice to four times within 4-10days of each procedure. Atter completion of series of PE1, follow up examination (range : 3 months - 1.5 Yearperiod) was done with angiography, CT or ultrasound and correlated with serum alpha-fetoprotein (AFP) level.Results : On follow up angiograms, the lesions completely disappeared or decreased in size without tumor vesselsor staining in 5 of 6 patients. On follow up CT of 6 patients, the lipiodol-laden HCCs were surrounded bynon-enhancing low density and the losion sizes were slightly decreased or not changed. These are suggestive ofnecrosis of tumor ltself and adjacent liver parenchyma. The tumors could not be detected on follow up ultrasoundexamination in 2 patients. Sercum AFP was decreased in 7 patients and was well corresponded to the results ofimaging modalities. Conclusion : The authors concluded that the combined TACE and PEI is an appropriate treatmentfor small HCCs having high surgical risks.