Radiation therapy for intermediate and advanced hepatocellular carcinoma without surgical indications is aimed at palliative treatment, and radical treatment for small and limited hepatocellular carcinoma with surgical indications but forgoing surgery can be the aim. Radiotherapy for both purposes includes only the primary tumor and does not have to include the lymphatic drainage area of the liver. For patients with portal vein carcinoma thrombosis, surgery and interventional therapy cannot achieve good results, and radiation therapy has unique advantages. For massive hepatocellular carcinoma, only local radiotherapy is given; for massive type with intrahepatic dissemination, local mass irradiation is given first. If local tumor responds to radiation and tumor regression occurs, then whole liver radiotherapy will be administered; otherwise, whole liver radiotherapy will be abandoned. For diffuse hepatocellular carcinoma, whole liver radiotherapy should be administered at the beginning. For patients with limited primary tumor and maximum diameter radiation therapy, there is no strict definition, but the following conditions can be used for reference: ① good general condition, tolerate radiation reaction, no serious liver function impairment and cirrhosis, no jaundice and ascites, patients with limited tumor and slow development, no distant metastasis, high palliative or radical radiation therapy is feasible; ② for patients with intrahepatic dissemination or diffuse hepatocellular carcinoma, good general condition (2) for patients with intrahepatic dissemination or diffuse hepatocellular carcinoma, good general condition, no jaundice and ascites, palliative whole liver radiotherapy is feasible. In addition, radiotherapy is the first choice of treatment for patients with portal vein cancer thrombosis because surgery and interventional treatment are not available.