PURPOSE: The purpose of this study was to identify nursing needs and burden of family caregivers of middle-aged patients with hepatocellular carcinoma. METHODS: The participants of this study were 101 family caregivers from 3 university hospitals in D city, South Korea. The levels of nursing needs and burden of family caregivers were measured using structured questionnaires from August 1, 2011 to February 29, 2012. The collected data were analyzed using t-tests, ANOVA, Scheffe tests, and Pearson's correlation coefficients. RESULTS: The greatest nursing need was for information about patients' health status. Among subdomains of burden, financial burden had the greatest mean score. Family caregivers with worsened health status since starting caregiving had significantly higher levels of total nursing needs and total burden. Total burden and physical burden scores showed significant correlations with all subdomains of nursing needs as well as total nursing need scores. CONCLUSION: Findings of this study suggest that family caregivers of middle-aged patients with hepatocellular carcinoma need provision of information about patients' health status and treatment plans, and financial support the most. Also maintaining family caregivers' health needs to be considered when providing nursing intervention for patients with hepatocellular carcinoma and their family caregivers.