Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related mortality. Hepatitis B & C accounts for most HCC occurrences. It is very rare to see a tumour thrombus extending into the right atrium of the heart as a result of the invasion of HCC. This complication has a very poor prognosis as mean survival time is about three to four months. We encountered such a rare case of hepatocellular carcinoma having extensive tumour thrombus extending into the right atrium without any cardio respiratory distress or clinical finding suggestive of cardiovascular involvement.