Objective To investigate the value of 18F fluorodeoxyglucose (18F-FDG) PET/CT imaging in postoperative follow-up of patients with hepatocellular carcinoma (HCC). Methods The 18F-FDG PET/CT imaging results of 86 patients with suspected recurrence and metastasis of HCC after operation who were examined in PET Center of the hospital during April 2011 to April 2016 were analyzed retrospectively. The diagnostic efficiency of 18F-FDG PET/CT for recurrence and metastasis of HCC after operation was evaluated. Results All cases were followed up for 13-59 months. 52 cases of recurrence and/or metastases were confirmed by histopathology or clinical follow-up. Among them, there were 27 cases with solitary intrahepatic recurrence, 6 cases with solitary extrahepatic metastasis, and 19 cases with intrahepatic recurrence and extrahepatic metastasis. With histopathology or clinical follow-up as the golden standard, the sensitivity, specificity and accuracy of 18F-FDG PET/CT in the diagnosis of recurrence or (and ) metastasis of HCC after operation were 94.23%, 88.24% and 91.86%, respectively. Conclusion The detection rate of recurrence and metastasis of HCC by 18F-FDG PET/CT imaging after operation is high, which is good for comprehensive evaluation of patient's condition.