There are six important developmental milestones for yttrium 90 microspheres in treatment of hepatocellular carcinoma (HCC). These milestones are: ① development of concepts in treatment of HCC; ② development of concepts in internal radiation therapy; ③ from basic, translational and clinical researches to clinical application; ④ internationally recognized indications for palliative treat ment of HCC; ⑤ from palliative to curative treatment of HCC after tumor downstaging with yttrium 90 microspheres using liver resection or liver transplantation; ⑥ non-surgical treatments using yttrium 90 microsphere as curative treatments. The developmental stages of yttrium 90 microsphere in treatment of HCC have undergone a very prolonged period and these stages will continue to evolve. As HCC is prevalent in China, permission of the State Food and Drug Administration to allow yttrium 90 microsphere to be clinically used on HCC patients in China will benefit a lot of patients who were not treatable by other means.