Abstract: Objective To investigate the efficacy and safety of sorafenib in treatment of advanced hepatocellular carcinoma （HCC）. Methods Forty-three mid-advanced patients with HCC who were treated with sorafenib for more than 3 months from June 2008 to December 2011 in Cancer Center of First Hospital of Jilin University were reviewed retrospectively. Twentytwo patients took oral sorafenib alone at a dose of 400mg twice daily. Twentyone patients were treated with sorafenib（400mg po, bid） combined with other regional therapies. The efficacy was evaluated by CT or MRI every 3 months according to the modified response evaluation criteria in solid tumors（mRECIST） and the median overall survival （mOS） time were observed during follow-up. The side effects were evaluated according to NCICTC 3.0 criteria. Results The efficacy of 43 patients could be evaluated. Two patients achieved complete response （CR）， 15 patients achieved partial response（PR），13 patients achieved stable disease（SD） lasting for more than 6 months. The disease control rate（DCR） was 69.8％. In sorafenib monotherapy group, none of them achieved CR， 2 patitents attained PR， 10 patients achieved SD lasting for more than 6 months. In combination therapy group, 2 patients achieved CR， 13 patients attained PR， and 3 patients were SD for more than 6 months duration. The disease control rate（DCR） of the combination therapy group was higher than that of sorafenib monotherapy group（85.7％ vs.54.5％，P=0.03）. The mOS of 43 patients was 22 months （4-39 months）. Subgroup analysis according to the BCLC stage suggested patients of stage A had not reached the mOS， while the mOS of patients with stage B was 12 months，and the patients with stage C was 9 months. the mOS of patients with ChildPugh grades A was longer than that of the patients with ChildPugh grades B（24.0 months vs.4.9 months，P=0.002）.Furthermore， the patiens treated with sorafenib and other regional treatments had longer mOS than the patients treated with sorafanib monotherapy（25.0 months vs.8.7 months，P=0.043）. The most common adverse effects were handfoot skin reaction， hypertension， diarrhea and so on. Only 3 patients got adverse effects in grade 3 and the other 40 patients were less than grade 2. Conclusion Sorafenib is safe and effective for advanced HCC and the side effects were tolerable.