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Ablative radiation therapy, also known as stereotactic body radiation therapy (SBRT) or stereotactic ablative body radiotherapy (SABR), has an evolving role in the treatment of hepatocellular carcinoma (HCC), owing to recent advances in technology. SBRT is primarily used when other local therapies are not feasible. Although evidence is limited, SBRT has been demonstrated to be an effective treatment with excellent local control. In this chapter, we discuss the role of SBRT as a curative local therapy for patients with early HCC.