Itchy skin in patients with liver cancer is most likely due to the deposition of bile salts on the skin, which causes the corresponding itchy skin symptoms. For patients with hepatocellular carcinoma, it is also related to the elevation of bilirubin, which is mostly considered to be caused by the elevation of total bilirubin due to the deterioration of liver function. The cause of elevated total bilirubin may be the obstructive jaundice caused by the compression of bile ducts by liver cancer tumors or invasion of bile ducts, resulting in elevated total bilirubin and direct bilirubin. It may also be caused by hepatocellular jaundice due to necrosis of the patient’s liver cells after the patient’s liver function has deteriorated, which may result in an increase in total and indirect bilirubin. Or the patient may have both obstructive jaundice and hepatocellular jaundice, with the possibility of mixed jaundice. In this case, the patient should be given further hepatoprotective treatment and, if necessary, symptomatic and supportive treatment with intravenous plasma and albumin infusion. In addition, if the patient’s liver function improves and bilirubin decreases, the itchy skin symptom will be significantly improved. Patients with hepatocellular carcinoma should actively consider surgical treatment, and after surgery, they should also consider interventional perfusion and embolization chemotherapy, as well as liver-protective therapy and symptomatic supportive treatment.