According to the typical clinical characteristics of hepatocellular carcinoma (HCC), recurrence and prognosis can differ dramatically between patients. Using RNA sequencing, we identified differential expression of the gene metallothionein 1M (MT1M) by comparing early-recurrence HCC (N = 11), no-recurrence HCC (N = 10), and normal liver tissues (N = 5). Reverse transcription-polymerase chain reaction was employed to test MT1M expression levels in 92 HCC tissue samples from a cohort of patients with whom contact was established for post-operative follow-up. Low MT1M expression correlated with high alpha-fetoprotein levels (P = 0.017) and tumor recurrence within 24 months after surgery (P = 0.029). Recurrence rates in high- and low-MT1M groups were significantly different (MT1M cutoff point = 0.066; P = 0.008). Moreover, the disease-free survival time of patients in the former was longer than that of those in the latter (median of 20.39 vs 14.35 months, respectively; P = 0.002). Among early-stage HCC patients (Barcelona Clinic Liver Cancer stage 0/A), those with reduced MT1M expression exhibited higher recurrence rates (37.5 vs 12.1%; P = 0.023). Low MT1M expression is associated with poor HCC prognosis following curative resection, and this also applies to the early stage of this disease.