Background At present, the majority of outcome studies of survival of hepatocellular carcinoma (HCC) post‐liver resection (post‐LR) present actuarial survival data, which often results in overestimation of survival. We sought to evaluate the actual 10‐year survival post‐LR for HCC and identify variables that are associated with long‐term survival. Methods We performed a retrospective review of 600 consecutive patients who underwent primary LR for HCC from 2000 to 2010 at our institution. Twenty‐eight patients (4.7%) with 90‐day mortality and 125 patients who were lost to follow‐up within 10 years were excluded leaving 447 patients who met the study criteria. Results There were 140 actual 10‐year survivors of which 57 (40.7%) had a recurrence within 10 years. The actual 10‐year overall survival (OS) rate of the 447 patients was 31.5% and the actual 10‐year recurrence‐free survival (RFS) was 18.6%. Multivariate analyses demonstrated that only age >65 years (OR, 0.29; p < .001) (OR, 0.973; p = .041) and presence of cirrhosis (OR. 0.37; p = .005) (OR, 0.31; p = .001) were independent factors negatively associated with actual 10‐year OS and actual 10‐year RFS, respectively. Conclusion Approximately one‐third of patients will survive over 10 years after LR for HCC. Amongst these 10‐year survivors, 41% had developed recurrent cancer within 10‐years of follow‐up.