The ultrasound-guided percutaneous punctual procedures, such as fine needle biopsy, ethanol injection therapy (PEIT) and radiofrequency ablation (RFA), have been commonly used for pathological diagnosis and treatment of hepatocellular carcinoma. However, needle-tract tumor implantation and peritoneal seeding after these procedures have been documented. In addition, there has been no consensus on the most effective treatment yet, and for such recurrent tumor. Hence, we have evaluated the efficacy of surgical resection of 4-patient cases with needle-track implantation and peritoneal seeding after percutaneous puncture procedures. The 4 patients were all males. Two patients underwent PEIT, 1 patient for RFA, and the other patient for needle biopsy. Needle-tract implantation was found in 2 patients, and peritoneal seeding was found in the others. Each implanted or seeded tumor was surgically resected. Only 1 patient with peritoneal seeding had local recurrence after the resection, and he was successfully treated by radiation therapy. These results suggested that the surgical resection might be effective for local control of needle-tract implantation and peritoneal seeding.