Abstract: Objective To evaluate efficacy and safety of advanced primary hepatic carcinoma（PHC） by transcatheter arterial chemoembolization（TACE） with raltitrexed treatment. Methods All 95 patients with advanced PHC confirmed by pathology or clinical diagnosis were enrolled from January 2012 to December 2013， dividing into experimental group （n=37） and control group （n=58）. Experimental group： raltitrexed （3 mg／m2） plus oxaliplatin （100 mg／m2）， pirarubicin （40 mg／m2） in TACE treatment， while control group： FUDR （1.0 g） combined with oxaliplatin （100 mg／m2）， pirarubicin （40 mg／m2）. Repeated treatment was given every 4-6 weeks and efficacy was evaluated after four weeks in accordance with the modified RECIST criteria （mRECISIT）， until efficacy evaluation for complete remission （CR）， liver function Childpugh C level or intolerable complications were occured. The response rate（RR）， disease control rate（DCR）， decreasing rate of alphafetoprotein （AFP）， progression free survival （PFS） and the incidence of adverse reactions were assessed， and the results were compared between the two groups. Results In experimental group and control group， the RR was 351％ and 327％（P＞005）， AFP decreasing rate was 40.5％ and 31.0％（P＞0.05）， the median PFS was 7 and 5 months（P＞0.05）， DCR were 86.5％， 67.2％（P=0.035），respectively. The main adverse events in both groups were nausea， vomiting， bone marrow suppression， fever and transaminase increase， the difference was not statistically significant （P＞0.05）. Conclusion Preliminary study has shown that the short-term curative effect of PHC by TACE with raltitrexed treatment is exact and the toxicity can be tolerated. But it still needs a large randomized controlled study to confirm the results.