Objective: To compare the short term efficacies between laparoscopic liver resection and open liver resection in treatment of small hepatocellular carcinoma. Methods: The clinical data of 52 patients with small hepatocellular carcinoma treated between August 2011 and November 2012 were reviewed. Of the patients, 20 cases underwent laparoscopic liver resection (laparoscopic group), while the other 32 cases were subjected to open liver resection (laparotomy group). The pre-, intra- and postoperative conditions between the two groups were compared. Results: The data between the two groups before surgery were comparable (all P>0.05). The difference in operative time between the two groups did not reach a statistical significance (P>0.05), but the intraoperative blood loss in laparoscopic group was significantly lower than that in laparotomy group (t=5.568, P=0.003). Comparison of the postoperative outcomes between the two groups showed that the liver function parameters in laparoscopic group were all better than those in laparotomy group (all P<0.05), the levels of white blood cells, neutrophils and C-reactive protein in laparoscopic group were all significantly lower than those in laparotomy group (t=0.727, 2.191, 5.691, all P<0.05), and the time to eating and ambulation as well as the length of hospital stay in laparoscopic group were all shorter than those in laparotomy group (t=15.838, 3.896, 7.638, 3.663, all P<0.01). Post-procedure complications occurred in none of the patients in laparoscopic group, but in 8 cases in laparotomy group (χ2=5.909, P=0.017). Conclusion: Laparoscopic liver resection for small hepatocellular carcinoma is safe, feasible, and is better than traditional open surgery in terms of short-term efficacy.