Abstract: The incidence of primary liver cancer with portal vein tumor thrombus（PVTT） is very high. It is an important and difficult problem in the research field of liver cancer because of poor therapeutic effect，short lifetime and more complications. The radiation treatments for primary liver cancer with PVTT were reported more and more frequently，including three dimensional conformal radiation therapy，stereotactic body radiation therapy，proton radiation therapy，internal isotope therapy，radiation therapy combined with other therapeutic approach，etc.The therapeutic approach should be individualized and sequential according to the patients condition and the type of PVTT. This article reviews the recent literature and the relevant issues concerning the radiation treatments for primary liver cancer with PVTT.