Abstract: At present, the treatment of primary liver cancer is mainly based on modern medicine. Studies have found that traditional Chinese medicine (TCM) can promote the apoptosis of hepatoma cells and regulate the immunity of human body by affecting multiple critical pathways involved in the development and progression of tumor. TCM plays an irreplaceable role in the treatment of liver cancer, and the focus on the etiology and pathogenesis of liver cancer is the key to achieving good efficacy. Although there are still no ideal anti-HBV drugs in TCM, intervention on the etiologies of dampness, heat, phlegm, toxin, stasis, and deficiency and the change in struggle between vital Qi and pathogen during each stage of disease progression may delay or even prevent disease progression, which is the treatment based on etiology and pathogenesis and is the theory that "treatment should focus on the principal cause of a disease". In clinical practice, modern medical treatment combined with TCM can improve patients' quality of life and reduce tumor recurrence, and TCM combined with sorafenib has stronger efficacy and fewer side effects. Meanwhile, further studies are needed to explore how integrated traditional Chinese and Western medicine therapy exerts a therapeutic effect on liver cancer and the detailed mechanism of action of TCM in the treatment of liver cancer.