Objective:There is no clear consensus on the better therapy [radiofrequency ablation (RFA) versus hepatic resection (HR)]for small hepatocellular carcinoma (HCC) eligible for surgical treatments. This study is a meta-analysis of the available evidence. Methods:Systematic review and meta-analysis of trials comparing RFA with HR for small HCC published from January 2000 to December 2009 in PubMed,Medline and CNKI. Pooled odds ratios(OR) with 95% confidence intervals(95% CI) were calculated using either the fixed effects model or random effects model. Results:Six randomized controlled trial,and nine nonrandomized controlled trials studies were included in this analysis. These studies included a total of 2 284 patients:1 213 treated with RFA and 1 071 treated with HR. The difference in overall survival at 1-year was not statistically significant between the RFA and surgery groups(P > 0.05). While the overall survival was significantly higher in patients treated with HR than in those treated with RFA at 3 years.(P < 0.05). And there were no differences in 1-year and 3-year recurrences between the RFA and surgery groups(P > 0.05). Conclusion:HR was superior to RFA in the treatment of patients with small HCC eligible for surgical treatments,particularly for long-term survival rate.