Hepatocellular (HCC) is the most common type of primary liver cancer and the fourth most common cause of cancer-related deaths globally.1 Although most cases of HCC were historically attributed to underlying chronic viral hepatitis, nonalcoholic fatty liver disease is projected to become the most common risk factor for HCC with the rising prevalence of obesity and diabetes mellitus and increasing availability of effective treatments for hepatitis B and C infection.2 Although patients with viral and nonviral HCC seem to have similar overall prognosis,3 prior data have suggested possible differential efficacy of systemic therapies by liver disease etiology. For example, sorafenib was shown to have greater efficacy in patients with chronic hepatitis C infection than other etiologies.4 The aim of our descriptive study was to report the effectiveness of lenvatinib in a real-world cohort of patients with nonalcoholic steatohepatitis (NASH)-related HCC.