Spontaneous regression of hepatocellular carcinoma is an extraordinarily rare phenomenon. Fewer than 20 occasions have been reported in the English medical literature. There have only been 5 case reports in Korea. Understanding of the mechanism of spontaneous regression of hepatocellular carcinoma will help us to establish new treatments for the disease. In this case report, we present a 53 year-old Asian male who showed spontaneous necrosis of hepatocellular carcinoma confirmed with pathology. He developed a febrile condition secondary to pneumonia for 2 weeks. After that hepatocellular carcinoma was observed to have been necrosed on an MRI scan and hepatic angiography. A right lobectomy of the liver was done because the possibility of residual microscopic cancer cells could not be ruled out. The pathologic finding confirmed the spontaneous near-total necrosis of hepatocellular carcinoma. The patient has recovered uneventfully and has been followed up for 7 months.