Objective To investigate the learning curve of laparoscopic ultrasound-guided microwave ablation in the treatment of hepatocellular carcinoma.Methods 50 patients undergoing laparoscopic ultrasound-guided microwave treatment of hepatocellular carcinoma performed by the same ultrasound physician were retrospectively analyzed.The patients were divided into 5 groups （from A to E） according to therapy time.Laparoscopic ultrasound scan to the lesion time，Laparoscopic ultrasound guided into the needle time，bleeding volume and complications were compared between the 5 groups. Results There were no significant differences between the 5 groups with respect of age，gender，tumor diameter and complications.The laparoscopic ultrasound scan to the lesion time in group A was（17.6±2.6）min and decreased to（5.5±0.8）min in group E（P=0.000）.The laparoscopic ultrasound guided into the needle time in group A was（268.0±42.6）s and decreased to（48.0±21.5）s in group E（P=0.000）.The bleeding volume in group A was（71.5±15.3）ml and decreased to（19.0±6.6）ml in group E（P=0.000）. Laparoscopic ultrasound scan to the lesion time curve and Laparoscopic ultrasound guided into the needle time curve ，Groups C and D are statistically significant learning inflection points. Conclusion From the learning curve of microwave ablation therapy guided by laparoscopic ultrasound in hepatocellular carcinoma，ultrasound physicians can learn such skill after performing 30 cases.