The intake of coffee and caffeine has been shown epidemiologically to be associated with improved liver function tests, mainly in the form of alanine transaminase and gamma glutamyl transferase, a reduction in the incidence of cirrhosis and hepatocellular carcinoma. These observations suggest that coffee drinking is protective to the liver. Hepatocellular carcinoma is a common tumour worldwide and amenable to both primary and secondary preventive strategies. Surveillance for hepatocellular carcinoma by six-monthly alpha fetoprotein and ultrasound scanning in patients with cirrhosis is essential.