This article reports the clinical characteristics of 38 cases of patients with hepatitis B (HB) which developed into primary hepatocyte carcinoma (PHC), during a period of observation for 2-28 years (average 11.4 years). These patients were admitted repeatedly for 2 to 12 times (average 3.4 times). The clinical characteristics of the development of the symptoms in these patients were as follows: 1. Liver function fluctuated again and again. Ninety percent of these patients with HB developed liver cirrhosis (LC). Subsequently they developed into PHC. 2. HBV markers were positive over a long period of observation. During the phases of LC and PHC the rates of positive anti-HBe were 23.5% and 54.5%, respectively (P < 0.05). Comparing with anti-HBe, the rate of positive HBeAg was lower. 3. During the phase of HB, 21.0% of these patients had elevated alpha FP (mean titer 80.0 ng/ml). During the phase of PHC, 65.8% of the patients had abnormal alpha FP (mean titer 635.9 ng/ml) (P < 0.01). Sustained high level of gamma-GT and the ratio of gamma-GT/ALT higher than 1.5 were dangerous signals (P < 0.05). The level of ALP in these patients with HB was below 170 u/L. But 50% of them had high level of ALP when they developed into PHC. During the phase of LC these patients were detected regularly with ultrasonic waves.