Abstract: ob＜x＞jective：To investigate the efficacy and safety of transarterial chemoembolization(TACE) combined with Apatinib plus Camrelizumab (TACE-Cam- Apa) versus TACE combined with apatinib (TACE- Apa) for patients with advanced hepatocellular carcinoma (HCC).Methods: A total of 76 patients with advanced hepatocellular carcinoma who received treatment in Affiliated Hospital of Xuzhou Medical University from July 2019 to December 2021 were eligible and included in this study ，including 37 patients treated with TACE-Cam-Apa and 39 patients with TACE-Apa；The differences in overall survival (OS)， progression-free survival (PFS) ，ob＜x＞jective response rate (ORR)，disease control rate (DCR) and adverse events (AEs) were compared retrospectively between the two groups.Kaplan-Meier method was used to evaluate survival time in two groups.Results：The patients in TACE-Cam-Apa group had prolonged OS(median ，13.7 vs. 10.6 months，P=0.046)，longer PFS (median，7.9 vs. 5.1 months，P=0.008) and higher ob＜x＞jective response rate (40.5%vs17.9%，P=0.008) and disease control rate (64.9%vs43.6%，P=0.030) than those in TACE-Apa group.There were no significant differences in the total incidence of adverse events and incidence of grade 3-4 adverse events between two groups ( total incidence of adverse events，89.2% vs. 92.3%，P=0.638；grade 3-4 adverse events，21.6% vs.15.4%，P=0.483).Conclusion:Compared with TACE-Apa，TACE-Cam-Apa could improve significantly the clinical efficacy of patients with an acceptable safety profile in advanced HCC patients.