Objective To understand the molecular mechanism of HBx in the carcinogenesis of hepatitis B virus (HBV) related hepatocellular carcinoma (HCC).Methods The literatures published in the past 5 years which are mainly about HBx and hepatocellular carcinoma were reviewed. Results HBx had many functions, such as cell malignant transformation, inhibiting DNA repair, trans-activation, inhibiting p53 and apoptosis. These functions together with its Fas/Fas-L interfering and caspase-3 inhibiting could contribute to the carcinogenesis and development of HBV relatde HCC. Conclusion HBx has broad spectrum of biological functions, which contribute to the carcinogenesis and development of HBV related HCC.