Surgical resections remain the primary curative interventions for hepatocellular carcinoma (HCC). However, lack of real-time intraoperative image guidance confines surgeons to subjective visual assessment of the surgical bed, leading to poor visualization of small positive nodules and the extension of diffuse HCC. To address this problem, we developed a wearable fluorescence imaging and display system (fluorescence goggle) for intraoperative imaging of HCCs in human patients. In this pilot study, both intravenous (i.v.) and transarterial hepatic (TAH) delivery of indocyanine green (ICG) were explored to facilitate fluorescence goggle-mediated HCC imaging. The results show that all primary tumors in patients (n=4) who received TAH delivery of ICG were successfully identified by the fluorescence goggle. In addition, 6 satellite tumors were also detected by the goggle, 5 of which were neither identifiable in pre-operative MRI and CT images nor by visual inspection and palpation. In the group (n=5) that received ICG by i.v., only 2 out of 6 tumors visible in the pre-operative MRI or CT images were identified with the fluorescence goggle, demonstrating the limitation of this delivery route for a non-tumor selective imaging agent. Comparative analysis shows that the HCC-to-liver florescence contrast detected by the goggle was significantly higher in patients that received TAH than i.v. delivery of ICG (P=0.013). This pilot study demonstrates the feasibility of using the fluorescence goggle to identify multifocal lesions and small tumor deposits using TAH ICG delivery in HCC patients.