Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide. Surgery, percutaneous ablation and liver transplantation are the only curative treatment modality for HCC. However, a majority of patients have unresectable disease at diagnosis. Despite radical treatment, high risk of tumor recurrence is the most common problem. Therefore, there is a need for effective treatment options for patients with advanced or recurrent HCC. For patients with advanced stage of HCC according to the Barcelona Clinic Liver Cancer staging system, the multikinase inhibitor sorafenib is the current standard of care. However, hepatic arterial infusion chemotherapy (HAIC) have been applied to advanced stage HCC with a view to improve the therapeutic indexes in Asia. HAIC provides direct drug delivery into tumor bed and a greater first-pass effect; also systemic side effects can be potentially minimized. However, the sample size of researches on HAIC was small and large randomized trials are still lacking. In this article, we describe the treatment efficacy of HAIC for advanced stage HCC and discuss future therapeutic possibilities.