Liver cancer is the fourth leading cause of cancer-related death worldwide. In Mexico, there is a high burden of liver cancer mortality in rural states, which affects both women and men equally. Thus, we aimed to describe the demographic and clinical characteristics of hepatocellular cancer (HCC) by sex in Mexico. Demographic and clinical information were extracted retrospectively from the medical records of patients with HCC initially treated (2015-2022) at participating institutions of a national survey across the country. The male-to-female ratio was calculated at the national and regional levels and the results were stratified by sex. Among 697 HCC patients, the age at diagnosis was 65.4±11.9y and 20% were diagnosed at ≥75y. The male-to-female ratio was 1.4:1, ranging from 1:1 in the northwestern and southwestern regions to 2.1:1 in the western region. The proportion of cirrhosis was similar between sexes; however, the etiologies for cirrhosis differed: cryptogenic cirrhosis was higher in women and alcohol consumption was higher in men. Men had a higher proportion of advanced HCC, poor/undifferentiated tumors, and ≥4 nodules than women. HCC in the Mexican population affects men and women at a 1.4:1 male-to-female ratio. This unique proportion by sex could be explained by the differences in the prevalence of risk factors across our heterogeneous country.