Purpose: Hepatocellular carcinoma (HCC) is the 6th commonest cause of cancer death annually in Australia. According to the Barcelona Clinic Liver Cancer guidelines, resection is the gold-standard therapy for HCC <3cm in size or with <3 lesions. However, most data concerning HCC resection is from Asia, with less being known about the Australian experience. We aim to present overall survival (OS) and progression-free survival (PFS) data from our high-volume unit in Sydney, Australia. Methods: We present a single-center retrospective cohort study of patients undergoing HCC resection from 2005-2023. Patient, operative and tumour data were collected via searching medical records. Results: The median OS and PFS of our cohort of 155 HCC resections were 85 and 35 months respectively. Tumour size (HR 1.0, 95% CI 0.96-1.1 p=0.459) and number of lesions (HR 1.1, 95% CI 0.93-1.2 p=0.362) were not significant predictors of prolonged OS. Predictors of poor OS include requirement of extended hepatectomy (HR 2.9, 95% CI 1.2-7.0 p=0.021), lymphovascular (HR 2.3, 95% CI 1.4-4.0 p=0.002) or perineural invasion (HR 3.7, 95% CI 1.2-9.5 p=0.018) on histopathology and tumour recurrence (HR 2.2, 95% CI 1.2-3.7 p=0.006). Poor PFS was predicted by requirement of an extended hepatectomy (HR 4.1, 95% CI 1.7-9.9 p=0.002), lymphovascular invasion (HR=2.0, 95% CI 1.3-3.3, p=0.003) and a TNM stage 3a (HR 4.1, 95% CI 2.2-7.8 p<0.001). Conclusion: In the Australasian context, requiring an extended hepatectomy, lymphovascular and perineural invasion, and advanced TNM stage are associated with poorer outcomes. Such patients may derive survival benefit from adjuvant atezolizumab and bevacizumab in accordance with the 2023 IMBrave-050 trial.