Aim: To evaluate wether it is safe and meaningful to treat octogenarians with microwave ablation for hepatocellular carcinoma. With an ageing population being healthier than previous generations, old limits for treating disease founded on patient age need to be revised. One of the most common tumour related death causes is hepatocellular carcinoma (HCC). With the development of minimally invasive therapies with curative potential, new ground is being broken offering treatments to older patients in the hope of achieving prolongation and better quality of life. Methods: In this retrospective single centre study of patients having a first microwave ablation therapy for HCC in a national referral centre for ablative liver treatments, septuagenarians (n = 161, age 70-80) were compared with octogenarians (n = 32, age 80-90). Results: Octogenarians selected for microwave ablation of HCC at a regional multidisciplinary team conference have similar outcomes as their younger control group. Survival, complications and length of stay are not different. Conclusion: Octogenarians who are fit for ablative treatment of HCC should not be disqualified on grounds of age, recognising that this group has an obvious immortality, or lead-time, bias as well as a probable selection bias in part explaining their good results.