We report on the treatment experience of five living-donor liver transplantation (LDLT) recipients for hepatocellular carcinoma (HCC) with pulmonary metastases. Between March 1998 and December 2007, five patients who underwent LDLT for HCC were identified with a routine follow-up of pulmonary metastases: Two patients underwent a radical resection for pulmonary recurrence of HCC, Two patients were only observed by palliative treatment, and one patient had chemotherapy using S-1/IFN. The survival range from pulmonary recurrence of HCC was 7.5 to 43.0 months and the median survival time was 18.9 months. Only one of the 5 patients who underwent a surgical resection of pulmonary recurrence is still alive without a new recurrence for a long period of time.