Surveillance programs and widespread use of medical imaging have increased the detection of hepatic tumors. When feasible, surgical resection is widely accepted as the curative treatment of choice, but surgical morbidity and mortality have spurred the development of minimally invasive ablative technologies over the last 2 decades. Microwave ablation has emerged as a promising thermal ablation modality with improving oncologic efficacy due to technical improvements and image guidance strategies. In this article, we overviewed microwave application in liver tumors, and discussed currently available equipment, clinical efficacy and safety, and provided comparisons with other commonly used therapies. We also introduced advanced ablative techniques and combination therapies that may help achieve precise ablation and further enhance the efficacy of microwave ablation.