Hepatocellular carcinoma (HCC) Is one of the commonest malignancies reported worldwide, ranked as the seventh most common malignant tumor in males and the ninth in females.The treatment of choice for a small percentage of patients with localized HCC is hepatic resection (HR) however; a large number of patients are not operable. For these patients PEIT has emerged as a treatment option, especially in those with poor hepatic function. In this study, an attempt was made to evaluate the feasibility and efficacy of this new modality for the treatment of 40 patients with hepatic neoplastic lesions with a mean age of 54.8 years.Recruited patients were divided into 2 groups according to the diameter of the lesion: Group I (n=19), patients with lesions 5 cm or less, Group II (n=21), patients with lesions greater than 5 cm.All patients were initially subjected to history taking, physical examination, laboratory studies, US and CT imaging and US guided FNAC of the lesions. Patients were only included when they were found to be unfit or refused surgery irrespective of tumor size, number, Child class, presence of ascites or portal vein thrombosis. All patients had evidence of cirrhosis. Informed consent was obtained from all patients.The overall complication rate in the study was 36.9% with one mortality (2.5%). AFP levels after PEIT decreased in 77.8% of patients, normalized in 38% and increased in 22.287% and AFP levels did not correlate well with the degree of tumor necrosis detected by FNAC. 38% of patients had a decrease in size of their lesions (one lesion disappeared), 9.5% had an increase in size and 52.5% had no change. Loss of enhancement of lesions on CT was found to be representative of the true degree of necrosis of the injected lesions as evaluated by FNAC and occurred in 71.25% of patients. Percent loss of enhancement was also found to be of prognostic value making CT essential for the follow-up of these patients.