Objective: The study of the alpha-fetoprotein oncomarker in the prognostic evaluation of the development of hepatocellular carcinoma against the background of chronic viral hepatitis. Methods: A study conducted in 194 patients with chronic viral hepatitis. In the serum of patients, the level of alpha-fetoprotein determined by ELISA, there was an analysis of ultrasound / CT / MRI data, as well as histological examination of biopsies. Results: The level of alpha-fetoprotein below 8.5 ng / ml was in 150 cases. An increase in alpha-fetoprotein up to 50 ng / ml was noted in 23 patients, the level of alphafetoprotein in the range of 101-150 ng / ml was noted in 3 cases. The level of alpha-fetoprotein in the range 201-250 was in 9 cases. At the level of alpha-fetoprotein 251 ng / ml in 5 cases. Conclusions: The elevated level of this tumor marker does not always speak in favor of primary liver cancer. In primary liver cancer, the level of alpha-fetoprotein may be below the upper limit of the norm. However, with an alpha-fetoprotein level above 250 ng / ml in all cases, the diagnosis was confirmed by visualization methods, and in 2 of them histologically. Diagnosis of hepatocellular carcinoma should be confirmed by visualization methods. The final diagnosis can be exhibited only by a histological method of investigation.