Abstract: Objective：To investigate the correlation between preoperative serum HBeAg level and tumor recurrence after radiofrequency ablation (RFA) in patients with hepatocellular carcinoma (HCC). Methods：Clinical data of 391 cases with hepatitis B background of HCC underwent RFA from June 2006 to June 2012 in Zhongshan Hospital, Fudan University were analyzed retrospectively. According to preoperative levels of HBeAg, patients were divided into HBeAg positive group (n=112) and HBeAg negative group （n=279）, with regular followedup after operation. The correlationship between HBeAg before RFA and tumor recurrence after RFA was analyzed. Results：The median recurrencefree survival time (RFS) was (23.00±1.99) months in HBeAg positive group, and the median RFS was (31.00±3.49) months in HBeAg negative group (P=0.002). Cox proportional hazard regression analysis showed that preoperative AFP level (HR 139.3, 95%CI 1.0521.845, P=0.021), serum HBVDNA level (HR 1.402, 95%CI 1.0131.939, P=0.041), and HBeAg levels (HR 1.389, 95%CI 1.0171.896, P=0.039) were the independent risk factors for survival in hepatitis B background HCC patients after RFA. Conclusions：Preoperative serum HBeAg level in patients with primary HCC is closely related to postoperative tumor recurrence. It is an independent risk factor for recurrence of HCC after RFA.