Background: Hepatocellular cancer (HCC) is the most common primary liver cancer and the third most common cause of cancer death globally. HCC incidence rate is declining in certain highly prevalent regions, however, continues to rise in many countries where the prevalence is currently low. To understand the trend of HCC incidence in India, we analyzed HCC incidence from various regions in India from 2004 to 2014. Methods: We obtained data on HCC incidence from the Population Based Cancer Registries (PBCR) of the National Cancer Registry Program. This registry includes data from different regions spread across India. We calculated age-standardized incidence rates (to WHO World standard population 2000) for periods of diagnosis (2004-05, 2006-08, 2009-11, and 2012-14). Results: From 2004 to 2014, HCC incidence rates increased relatively by 11%. When compared to data from 2004-2005, HCC incidence rate increased absolutely from 3 per 100,000 persons to 3.3 per 100,000 persons in 2012-2014. From 2004 to 2014, the relative increase in incidence rate was 13.3% in males and 7.4% in females. Conclusions: Rising HCC incidence rate is a cause for concern in India. Globally Nonalcoholic fatty liver disease (NAFLD) is swiftly becoming the most important cause of HCC. The rise in HCC incidence in India could be likely due to the increasing prevalence of NAFLD. Effective strategies are needed to improve surveillance and early diagnosis in patients with high risk of developing hepatocellular cancer. NAFLD preventive strategies must be an urgent public health measure in India.