Hepatocellular carcinoma (HCC) is one of the malignant tumors causing severe threats to human health worldwide. Especially in China, the proportion of patients with middle-advanced HCC upon initial diagnosis exceeds 70%, and most patients miss the opportunity of surgery. High incidence and mortality rates of HCC make the study of treatment strategy become the hot spot in medical community. In recent years, conversion therapy has become an important option for inoperable patients. Through targeted drugs, immunotherapy and topical treatment, partial patients benefit from unresectable to resectable conversion and obtain favorable prognosis. With the updates and expansion of the concept of conversion therapy, it is still necessary to further investigate and analyze the scientific and individualized selection of treatment regimen and accurately grasp the timing and safety of surgery after conversion therapy.