Background and Aims: After the introduction of Milan criteria (MC), liver transplantation (LT) has been recognized as the best treatment for hepatocellular carcinoma (HCC). However, MC are too restrictive criteria. Recently, several groups have introduced expanded criteria for selection of LT candidates. Methods: We retrospectively analyzed a cohort of 210 patients transplanted for HCC from 1988 to 2008, categorizing them according to MC (considered as the criterium of comparison) and thirteen expanded criteria (Padua, Valencia, UCSF, TTV/AFP, CUN, Up-to-seven, Seoul, Tokyo, Kyoto, Asan, Dallas, Sapienza and Hangzhou criteria). Results: The mean follow-up time was 4.5±4.2 years. HCC recurrence was observed in 27 patients (13%). In 29.5% of patients MC were exceeded. By applying the parameters of the thirteen modified expanded criteria, we observed a 9–31% range of increase in the number of LT patients. The most conservative were Padua criteria, while the less conservative were Hanghzou criteria. Upto-7 criteria showed intermediate results (19%). No differences were observed analyzing patient and disease-free survivals of the recipients who meet the fourteen criteria (67.2–70.4% and 91.7– 88.3%, respectively). Whereas, significant differences were observed in survival rates of patients who did not fulfill criteria, with progressive decreased survivals in less conservative criteria. MC presented the higher sensitivity and the lower specificity for the risk of recurrence (63% and 75%, respectively), while Hanghzou criteria showed the opposite results (33% and 96%, respectively). Analyzing the recurrence rates, we noted that no substantial differences were observed between the patients who met all the criteria, also the less conservative ones (MC: 7% versus Hanghzou criteria: 9%), while a major number of recurrence were detected in recipients who exceeded less conservative criteria (MC: 27% versus Hanghzou criteria: 56%). Conclusions: Expanded criteria does not seem to decrease survivals and to not significantly improve HCC recurrence, consenting more potentially curable HCC patients to became LT candidates. Only patients who do not fulfil less conservative criteria have a very increased risk of HCC recurrence. However, an universally recognized expanded criteria does not already exists: every center could select the best criteria respect to its effective LT volume.