Introduction: Hepatocellular carcinoma (HCC) is the sixth most common cancer worldwide and it is tied with gastric cancer as the third leading cause of cancer mortality. Survival in HCC has been established in literature, it varies by the etiology, stage of cancer at diagnosis, patient comorbidities and treatment. However, the impact of socioeconomic status (SES) on HCC survival is less clearly identified. Methods: The relationship between socioeconomic status (SES) variables and HCC mortality was examined using the Surveillance, Epidemiology, and End Results (SEER) Program 18 registry. We included HCC cases diagnosed between 2010 through 2018. The following SES data were gathered: race, insurance status, and marital status. Covariate survival analyses were conducted using a multivariable Cox proportional hazard model to estimate hazard ratios (HR), 95% confidence interval (CI), and survival curves for SES variables. All analyses were conducted using SPSS software, version 28.0 (IBM). Results: We have included 45,524 patients diagnosed with HCC between 2010 and 2018. Compared to insured individuals, uninsured and patients receiving Medicaid were at 94% and 29% higher risk of mortality (HR 1.949, 95% CI 1.845-2.059, HR 1.291, 95% CI 1.256-1.328, respectively). The mortality was also significantly higher by 7% in single (never married) and 9% in widowed (HR 1.078, 95% CI 1.037-1.121, and 1.097, 95% CI 1.047-1.150, respectively), while statistically lower by 10.1% in married individuals compared to divorced. Compared to females, males were at higher risk of mortality by 15% (HR 1.152, 95% CI 1.122-1.183). Finally, as regards to racial differences, risk of death was statistically lower in white and other races compared to black by 8.6% and 26% (HR 0.94, 95% CI 0.884-0.945 and HR 0.737 95% CI 0.706-0.769, respectively). (Table) Conclusion: This study demonstrates the impact of SES variables on HCC mortality, suggesting that SES is an independent predictor of liver cancer mortality. Married and insured had the most favorable survival outcome, while uninsured and single had the lowest. Moreover, white population is at lower mortality risk compared to black. Preventive interventions need to be more focused on the disadvantaged groups in order to reduce health disparities related to liver cancer mortality. Table 1. - The Cox Proportional-Hazards Model associating SES Variables and Hepatocellular Carcinoma Survival Covariates HR (95% CI) p-value Insurance Status: Insured Reference Any Medicaid 1.291 (1.256-1.328) < 0.001 Insured/No specifics 1.183 (1.147-1.220) < 0.001 Uninsured 1.949 (1.845-2.059) < 0.001 Age 1.023 (1.022-1.024) < 0.001 Gender Female Reference Male 1.152 (1.122-1.183) < 0.001 Marital status Divorced Reference Married (including common law) 0.899 (0.868-0.932) < 0.001 Separated 1.020 (0.937-1.109) 0.652 Single (never married) 1.078 (1.037-1.121) < 0.001 Unmarried or Domestic Partner 0.805 (0.661-0.981) 0.031 Widowed 1.097 (1.047-1.150) < 0.001 Race Black Reference White 0.914 (0.884-0.945) < 0.001