Abstract: Tumor necrosis factor-α (TNF-α) is a multifunctional inflammatory cytokine that has a bidirectional regulatory role in the occurrence and development of tumors. TNF-α participates in various regulatory pathways for the occurrence and development of hepatocellular carcinoma (HCC), but the mechanisms are not fully clear. Vascular endothelial growth factor (VEGF) and nuclear factor kappa B (NF-κB) signal pathways are considered as important roles in the occurrence and development of HCC. Peripheral blood TNF-α concentration and tumor tissue TNF-α concentration have shown good predictive values for the prognosis of HCC patients after receiving some treatments. The prognostic predictive value of TNF-α for HCC patients receiving precise radiotherapy needs to be further clarified.