Portal vein thrombosis is caused by hepatocellular carcinoma invading the portal vein and portal vein branches, which is a common clinical manifestation and an important poor prognostic factor of hepatocellular carcinoma. Portal vein thrombosis is one of the common complications of hepatocellular carcinoma. Hepatocellular carcinoma patients with portal vein thrombosis have poor liver function, high risk of intra- and extra-hepatic metastasis and combined portal hypertension, and usually have a poorer prognosis. Some studies have shown that patients with hepatocellular carcinoma combined with portal vein thrombosis tend to have rapid progression of their disease. Patients with hepatocellular carcinoma combined with portal vein thrombosis have a variety of treatments to choose from, such as surgical treatment, administration of targeted drugs such as sorafenib or lenvatinib, radiotherapy, transcatheter arterial chemoembolization, hepatic artery perfusion chemotherapy, and other methods, and the decision of which treatment to use should be made based on the individual patient’s condition. Therefore, patients with portal vein thrombosis should go to the hospital in time and choose appropriate treatment methods under the guidance of doctors, and standardized treatment is conducive to prolonging the survival period of patients.