Abstract: Objective To observe the efficacy and safety of camrelizumab plus tyrosine kinase inhibitor (TKI) combined with transcatheter arterial chemoembolization (TACE) in the treatment of middle and advanced liver cancer.Methods A total of 113 patients with middle and advanced liver cancer who were treated with camrelizumab plus TKI combined with/without TACE were retrospectively analyzed. The patients were divided into two groups:a carbazide plus TKI combined with TACE group (an observation group) and a camrelizumab plus TKI group (a control group). Both groups were compared for overall survival (OS), progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR) and the incidence of adverse reactions. Meanwhile, the factors influencing the prognosis of patients were analyzed.Results The observation group was superior to the control group in median OS (18.2 months vs 12.3 months, P<0.001), PFS (7.4 months vs 5.9 months, P=0.023), ORR (48.1% vs 18.6%, P=0.001) and DCR (75.9% vs 59.3%, P=0.026). The incidence of adverse reactions such as fever, nausea and vomiting, abdominal pain and liver function injury in the observation group was remarkably higher than that in the control group (P<0.05). There was no significant difference in the incidence of other adverse reactions between the two groups. Multivariate analysis showed that portal vein tumor thrombus and combined use with TACE were the independent risk factors influencing the prognosis of patients.Conclusions Compared with camrelizumab plus TKI alone, carrelizumab plus TKI combined with TACE can prolong the OS and PFS of patients with middle and advanced HCC, improve the local control rate of tumor, and do not aggravate adverse drug reactions.