Background and Aim: Liver stiffness (LS) value determined using transient elastography (TE) can be used to assess the degree of liver fibrosis. The study investigated whether TE can predict the recurrence of hepatocellular carcinoma (HCC) after radiofrequency ablation (RFA). Methods: This study retrospectively enrolled 228 patients with HCC who received TE and RFA as the first-line treatment for HCC between 2008 and 2015. Cox regression analysis was used to identify independent predictors of HCC recurrence. Results: The median age of the study population (170 men and 58 women) was 61years. During the study period, HCC recurrence and mortality developed in 125 (54.8%) and 37 (16.2%) patients after RFA, respectively. Liver cirrhosis, platelet count, multiple tumors, and LS value were the independent predictors of HCC recurrence. When the study population was stratified into early (= 12months) recurrence groups, LS value was an independent predictor of late recurrence, along with liver cirrhosis and spleen diameter. The risk of late recurrence was higher in patients with LS values of 13kPa than in those with LS values of >= 13kPa (adjusted hazard ratio [HR]=4.507, 95% confidence interval [CI] 2.131-7.724, P<0.001). Recurrence was the only predictor of overall survival (HR=18.583, 95% CI 2.424-142.486, P=0.005). Conclusions: Findings of this study suggest that LS measurement using TE can be a useful predictor of HCC recurrence after RFA.