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Objectives: AKR1B10, first cloned from liver cancer tissues, has recently been reported to be up-regulated significantly in hepatocellular carcinoma (HCC) tissues, but the relationship between serum level of AKR1B10 and the risk of HCC is not understood., Methods: 170 HCC patients and 120 health donors from October 2014 to March 2017 were recruited in the affiliated hospital of Guilin Medical University. Serum AKR1B10 in all cases were detected and in 30 HCC patients were analyzed preoperatively and postoperatively by Time-resolved fluoroimmunoassay., Results: The level of serum AKR1B10 was significantly higher in HCC patients (1800.24±2793.79) than in health donors (129.34±194.129), and downregulation of serum AKR1B10 in HCC patients was observed after hepatectomy. When samples were grouped according to the serum level of AKR1B10 (≥232.7pg/ml), serum AKR1B10 positively correlated to serum AFP (χ 2 =6.295, P=0.012), ALT (χ 2 =18.803, P=0.000), AST (χ 2 =33.421, P=0.000), tumor nodule number (χ 2 =6.777, P=0.009), cirrhosis (χ 2 =43.458, P=0.000), and tumor size (χ 2 =6.042, P=0.014) in the Chi-square test., Conclusions: Diagnosis of HCC could be improved using the both predictors of serum AKR1B10 and AFP. AKR1B10 was thus considered to be a new serological biomarker for HCC., (Copyright © 2019 Elsevier España, S.L.U. All rights reserved.)