<p>The integration of artificial intelligence (AI) into hepatocellular carcinoma (HCC) management introduces significant ethical challenges, which are shaped by the disease’s unique epidemiology and clinical complexity. In this review, we systematically analyze these challenges through the lens of the World Health Organization (WHO)’s ethical principles. To address them, we discuss practical strategies including federated learning (FL) for privacy-preserving model training, differential privacy for sensitive genomic data, interpretable AI method to enhance transparency, and adherence to standardized reporting frameworks. Furthermore, we examine global governance approaches and their implications for HCC care. Embedding ethics-by-design and promoting equity-driven AI deployment are essential to ensure that technological innovation enhances patient safety and fairness without compromising autonomy or trust.</p>