Liver cancer genetic testing is useful and has some guiding significance on the effect of drug-targeted therapy for liver cancer, but it is of little significance for small liver cancers that are mainly treated by surgery without drug-targeted therapy. Liver cancer is a malignant tumor, and the main treatment options include surgical resection, radiotherapy, chemotherapy, immunotherapy, and targeted drug therapy. Genetic test provides a basis for patients to choose gene-targeted drugs. Targeted drugs are an emerging method for treating liver cancer, with better therapeutic effect and less damage to the body as its advantages, and its application in clinic is gradually expanding at present. Genetic testing can also be used to predict the effect of immunotherapy for liver cancer. In addition, liver cancer is hereditary, and genetic testing can determine whether a person has the risk of liver cancer, so as to achieve early detection, early diagnosis and early treatment. However, some small liver cancers in early stage can achieve good therapeutic effect through surgical treatment and often do not need to be treated with targeted drugs, therefore, these types of liver cancers do not need to undergo genetic testing.