e22521 Background: Liver cancer represents the sixth most frequent neoplasm and the third leading cause of cancer death worldwide, although it possesses an heterogenous incidence and mortality. In Peru, its mortality rate distribution is unknown. We aimed to explore the spatio-temporal distribution of liver cancer mortality rate according to Peruvian geographical regions. Methods: We obtained data from liver cancer deaths between 2003-2017 from the Peruvian Ministry of Health Registry. Population data was obtained from The National Institute of Statistics and Informatics (INEI, Peru). Age-standardized mortality rate (ASMR) was calculated based on the 2011 world standard populations. Spatial autocorrelation was determined according to Moran’s Index and the Local G Cluster Map to explore the cluster patterns between regions. Results: During the study period, 18,427 deaths for liver cancer were reported on the national death system. The liver cancer mortality rate in Peru increased from an ASMR of 4.1 (95% CI: 3.4, 4.8) in 2003 to 4.4 (95% CI: 3.8, 5.0) in 2017, with an average mortality rate of 4.9 (95% CI: 4.6, 5.2) by 100 000 persons-year. According to the political regions of Peru, the mortality rate distribution showed a spatial variation (ASMR of 0.6 to 12.2 per 100 000 persons-year); the mortality rate was high in coast regions and low among highlands regions. The ASMR spatial distribution showed a significant spatial autocorrelation (Moran’s I: p < 0.05). During the study period, the ASMR showed a significant increasing and decreasing mortality in several geographic regions and remained constant in other regions. Conclusions: In Peru, the liver cancer mortality rate shows a spatial and temporal variation according to geographical regions. The increase in the mortality rate in some regions requires further identification of local risk factors to implement programs aimed at reducing incidence and mortality.