A 45-year-old woman underwent hepatectomy for hepatocellular carcinoma developing after 2 renal transplants. She had a solitary hepatocellular carcinoma and central bisegmentectomy of the liver was performed. Administration of immunosuppressants was continued to maintain renal function in the perioperative period. Although our patient suffered from severe pneumonia postoperatively, she recovered without a decline in renal function. She has been alive for 1 year and 3 months after hepatectomy with hepatocellular carcinoma recurrence in the remnant liver. Any patient undergoing hepatectomy for hepatocellular carcinoma after renal transplantation should be managed as an immunocompromised host. Previously reported cases of hepatectomy for hepatocellular carcinoma in renal transplant recipients were reviewed.