The pathophysiologic mechanisms recognized as inducing changes in the cell cycle and its regulation that enables carcinogenesis to occur are presented. More importantly, the mechanisms thought to be most important in each metabolic disorder that can terminate in the development of a hepatic cancer are identified. Often, more than one mechanism is involved and it is the sum mutation of these metabolic events with environmental hazards and exposures that enable cancer to develop or not in an individual with a metabolic disease having an association with hepatic cancer.