Abstract: This article aims to explore whether clinicians and surgeons in China have made enough progress to step into 'Surgery 4.0' in management of primary hepatocellular carcinoma (HCC). As for 'Surgery 4.0', the term was first introduced in 2018 by Hooshair A to describe the four important stages of development in surgery, and each of these stages developed as a result of new scientific inventions and applications at the material time periods. These four stages of surgical developments are: Surgery 1.0 (from 18th to 20th centuries, also called the era of scientific surgery); Surgery 2.0 (1950 to 1980, the era of ultra-major and transplant surgery); Surgery 3.0 (1980 to early 21st century, the era of minimally invasive surgery); and Surgery 4.0 (from early 21st century, the era of digital surgery). Digital science brings drastic changes in medicine and health-care. Surgery 4.0 is driven by the use of big data, artificial intelligence, automation, modern robots and 5G communication, which achives a preliminary success in surgical field. However, the application of Surgery 4.0 in diagnosis and treatment of HCC is still at its embryonic stage.