Objective Contrast enhanced ultrasound (CEUS) has been developed as a promising modality in the diagnosis of hepatocellular carcinoma (HCC).In this research,we aimed to investigate the relationship between quantitative parameters of CEUS and tumor recurrence after microwave ablation (MWA).Materials and methods We prospectively reviewed database of patients who received MWA for HCC at our department between March 2006 and March 2015.All the patients were pathologically diagnosedwith HCC,with single lesion, a largest diameter of 5 cm or less,liver function of Child A or B, no portal vein thrombosis, no bile invasion, no extrahepatic metastases,without cardiovascular and kidney diseases,and did not receive other liver-directed therapy before ablation.CEUS, contrast-enhance MRI were performed before ablation, 1 month,3 months,6 months after treatment, and at a 3~6 month interval thereafter.The quantitative parameters of CEUS were acquired by Sonoliver software.The patients were divided into early recurrence group (recurrence within one year),late recurrence group (recurrence after one year) and no recurrence group according to their follow-up imaging.Quantitative parameters of CEUS were compared between different groups.Results A total of 124 patients with single lesion of HCC were ultimately enrolled in this study.Among the quantitative parameters of CEUS before treatment,tRT, tTTP etc.were significantly different between non-recurrence group and recurrence group.Additionally, tRT etc.of early recurrence group were different with that of non-recurrence group.tPI etc.were different between late recurrence group and non-recurrence group.Logistic regression showed that tRT etc.were related to tumor recurrence after ablation.Conclusion CEUS could predict tumor recurrence of HCC after microwave ablation.