Hepatocellular carcinoma is one of the most frequent tumours in the world - its rate of incidence is increasing. The prognosis is not favourable as, when diagnosed, around 75% of patients present an advanced stage of the disease, and this rules out all radical treatment; in such cases chemotherapy and non-invasive radiotherapy have limited results. There are two therapeutic approaches open to patients who are not subject to a radical treatment and who do not present metastases at a distance from the primary site: chemoembolization and metabolic arterial radiotherapy with iodine 131-labelled-Lipiodol or yttrium 90 labelled microspheres. The efficacy of 131I-Lipiodol treatment has been proved both in the cure of hepatocellular carcinomas (HCC) with portal vein thrombosis and as an adjuvant treatment in HCCs operated to reduce the risk of recurrences. This treatment is almost as effective but it is tolerated much better than chemoembolization. As a palliative, it involves a partial answer in 12% - 66% of cases. On the other hand 131I-Lipiodol has a lasting antalgic action in case of hyperalgic HCCs. There can be frequent unimportant side-effects and, rarely, side-effects that can cause death (pneumopathies, liver failure). Lastly, radioprotective reasons require patients to be hospitalized and isolated in a protected room for 8 days. The use of yttrium 90 labelled microspheres represents a potentially efficacious therapeutic solution but the risk of radiation caused pneumopathy calls for the performance of a scintigraphy with intra-arterially injected 99m Tc-MAA and their exists the risk of serious haemmorrhage in the digestive tract. On the other hand a regression with this technique is less relevant than with I-Lipiodol. Lastly, studies are under way on the development of new agents that can be used in intra-arterial radiotherapy (rhenium 188 labelled Lipiodol, radiolabelled antibodies).