Abstract: Objective：To explore the prognostic value of total bile acid (TBA) for patients with hepatocellular carcinoma. Methods：The clinical data of 145 patients with hepatocellular carcinoma were collected and their overall survival time was followed up. The differences of clinical factors between TBA high group and TBA normal group were compared. The prognostic factors affecting the overall survival of patients with hepatocellular carcinoma were analyzed by univariate and multivariate analysis. Results：There were significant differences in liver function between TBA high group and normal group. The proportion of patients with serum total bilirubin＞17.1 μmol/L (22.6% vs 7.2%), albumin＜35 g/L (32.3% vs 7.2%), GGT＞70 U/L (59.7% vs 39.8%), and PT＞14 s (27% vs 7.2%) were significantly higher in TBA high group than those in TBA normal group （P＜0.05）. The multivariate analysis results showed that TBA＞10 μmol/L (HR=1.595, P=0.029), portal vein invasion (HR=2.102, P=0.005), and distant metastasis (HR=1.922, P=0.035) were independent risk factors for overall survival of patients with HCC. Conclusions：TBA is an independent prognostic factor for patients with hepatocellular carcinoma.