Hepatocellular carcinoma (HCC) is the third most deadly malignancy worldwide, and its high incidence and mortality rates highlight the urgent need for treatment. Although surgical resection and liver transplantation provide the possibility of radical cure for HCC, most patients still face a high risk of recurrence due to low diagnostic rate during the early stage. The latest treatment strategies, especially the use of immune checkpoint inhibitors (ICIs), have paved a new way to improve clinical prognosis. However, the potential of neoadjuvant therapy in early treatment of HCC has not been fully unleashed. In this article, the role, challenges and future development direction of neoadjuvant therapy in the treatment of resectable HCC were illustrated, aiming to provide a more comprehensive and effective treatment for HCC patients. The existing evidence of neoadjuvant therapy was analyzed and its potential in reducing recurrence and prolonging survival was investigated to bring innovative ideas for the treatment of HCC.