Abstract: Objective To evaluate the efficacy and safety of thermosensitive embolic material-transarterial chemoembolization (TEM-TACE) in the treatment of moderate and advanced hepatocellular carcinoma. Methods A total of 40 patients with moderate and advanced hepatocellular carcinoma who underwent either TEM-TACE or conventional transarterial chemoembolization (C-TACE) at Xuzhou Municipal Hospital Affiliated to Xuzhou Medical University from December 2020 to August 2023 were enrolled. Their clinical data were collected for retrospective analysis. According to the type of embolic material used, the patients were divided into two groups (n=20): a TEM-TACE group and a C-TACE group. Both groups were compared for clinical efficacy, survival rates, changes in liver function, and the incidence of post-embolization syndrome.Results The number of patients in the TEM-TACE group who received intervention treatment once or twice was higher than that in the C-TACE group (P>0.05). At post-treatment 1 month, 3 months, and 6 months, the objective response rates (ORR) in the TEM-TACE group were 65%, 60%, and 50%, respectively, and the disease control rates (DCR) were 80%, 75%, and 70%, respectively. In the C-TACE group, the ORRs were 75%, 75%, and 55%, and the DCRs were 85%, 80%, and 80%, respectively; these differences were not statistically significant (P>0.05). The median progression-free survival (mPFS) in the TEM-TACE group was 8.1 months (95% CI: 6.9-9.3 months), and the median overall survival (mOS) was 14.2 months (95% CI: 11.5-16.7 months). In the C-TACE group, the mPFS and mOS were 8.2 months (95% CI: 5.4-11.0 months) and 12.5 months (95% CI: 10.3-14.7 months), respectively. At post-treatment 3 months, the levels of aspartate aminotransferase and total bilirubin were significantly higher in the C-TACE group than in the TEM-TACE group, with statistically significant differences (P<0.05). There was no statistically significant difference in the incidence of post-embolization syndrome between the two groups (P>0.05).Conclusions TEM-TACE demonstrates good efficacy and safety in the treatment of moderate and advanced hepatocellular carcinoma.