Surgical treatment is the most effective way to get a radical cure for liver cancer. Currently, most patients with advanced liver cancer cannot obtain radical surgical treatment. In clinical practice, it is necessary to pay attention to the down-stage conversion treatment strategy of advanced liver cancer. This article reported a patient with advanced liver cancer and portal vein tumor thrombus admitted to our hospital recently, who underwent precise down-stage treatment and radical surgical resection. Meanwhile, reviewing relevant literature in order to improve the treatment effect of advanced liver cancer.