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Small RNA molecules such as microRNAs, for many years considered to be superfluous genomic material, are now known to play important regulatory roles in apoptosis, cell proliferation and differentiation, angio-genesis and thus in carcinogenesis. Primary liver carci-nomas such as hepatocellular carcinomas, cholangio-carcinomas and mixed variants show a rising incidence with high mortality among affected patients but lack ef-fective targeted therapies except the new multiple kinase inhibitor Sorafenib. This review elucidates the recent contributions of miRNA gene expression analyses to a better understanding of the complex molecular interac-tions in liver carcinogenesis and highlights their future promise to provide novel tools for improved diagnos-tics, more accurate prognostic assessment and tailored molecular therapies in liver cancer