Objective:To evaluate the clinical efficacy of transcatheter arterial chemo-embolization (TACE)combined with sorafenib on the treatment of primary advanced hepatocellular carcinoma. Methods:Totally 115 patients with primary hepatocellular carcinoma (TNM stage)were randomly divided into two groups:58 cases in treatment group received TACE + sorafenib treatment ;57 cases in control group received TACE therapy. The short-term effect,long-term survival,and adverse reactions were analyzed between two groups. Results:Two months after treatment,the disease control rate in the treatment group and the control group was 74.1 % vs 64.9%,there was no statistically significant difference betweer two groups(P = 0.282). The median survival time in the treatment group was 13.2 months,and that of the control group was 9.6 months,and there was a significant difference between two groups(P < 0.001). One-year survival rate of the treatment group and the control group was 62.5 % and 32.1 %,respectively,and there was a significant difference between two groups(P = 0.001). Adverse events in two groups were mainly gastrointestinal reactions,bone marrow suppression,mucocutaneous reactions and liver abnormalities. The incidence of oral mucositis and hand-foot skin reaction in the treatment group was significantly higher than that of control group,and there were significant difference between two groups(P < 0.001,P < 0.001). Conclusion:TACE combined with sorafenib in patients with advanced hepatocellular carcinoma can improve patients’ 1-year survival rate with the mild side effects.