Abstract : Background: Hepatocellular carcinoma (HCC) is the most common primary liver malignancy, yet it is typically diagnosed late via imaging. PIVKA-II has recently gained renewed interest as a potential HCC surveillance tool, however literature before 2016 only involves small retrospective studies from western countries and Japan where the aetiology for HCC is HCV infection. Aim: This article aims to review studies on PIVKA-II to diagnose or survey for HCC in Asian countries where HBV is the main aetiology. A search was performed using Scopus, PubMed, and Web of Sciences database published from the year 2016 to 2021 focusing on studies on PIVKA-II for early HCC surveillance. Result: Seven articles including one review done were selected for this review. Conclusion: PIVKA-II is comparable to AFP in terms of sensitivity and specificity for early HCC diagnosis, but the combination of both has the best performance. PIVKA-II can be a promising surveillance tool for HCC, but more studies need to be done on the prognostic potential of PIVKA-II as well.