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Recurrence of hepatocellular carcinoma (HCC) following liver transplantation is a major event, significantly impacting post-transplant survival. It is responsible for half of all deaths that occur in the first five years post-transplant for HCC. The median overall survival time after recurrence is approximately twelve months. The prognosis of this disease can be improved by early identification of recurrence through monitoring strategies that still need to be defined. Prevention is mainly achieved using immunosuppressive drugs at a minimal effective dose, in particular calcineurin inhibitors. The clinical presentation at diagnosis is mostly extrahepatic. The delay between transplantation and recurrence has a major prognostic impact and seems to reflect different aggressiveness profiles of the disease. Therapeutic management is poorly codified due to the absence of prospective studies and the lack of multicenter studies. Some patients may benefit from local approaches with a sustainable curative objective, while tyrosine kinase inhibitors are the most documented systemic treatments with an acceptable safety profile. The optimal management of calcineurin inhibitors or mTOR inhibitors in case of recurrence has not yet been defined, but immunosuppressive drugs do not seem to increase the toxicity of systemic treatments. The use of immune checkpoint inhibitors remains marginal and is associated with major risks of graft rejection and related mortality.