Hepatocellular carcinoma (HCC) is imposing a growing global health burden, with China accounting for nearly half of incident cases and mortality worldwide. Early screening is critical to improving survival in high-burden regions. However, the global standardized screening rate for high-risk populations is less than 24%, and HCC screening currently faces severe challenges. We synthesize recent advances in HCC screening, including optimized serum biomarkers, evolving imaging techniques, and validated models. Emerging liquid biopsy technologies and artificial intelligence further demonstrate considerable promise for enhancing noninvasive detection efficacy. Multifaceted collaboration among policymakers, healthcare systems, and communities is essential to implement effective screening programs and ultimately improve survival outcomes.