Hepatocellular carcinoma (HCC) is one of the malignant tumors with high mortality worldwide, especially in China. Although radical resection can be achieved in the early stage, postoperative recurrence seriously limits the long-term survival of HCC patients. In recent years, perioperative comprehensive treatment strategy has become a research hotspot, the core of which is to reduce the risk of postoperative recurrence and improve clinical prognosis through multidisciplinary team (MDT) cooperation by using preoperative neoadjuvant therapy and postoperative adjuvant therapy. Preoperative neoadjuvant therapy can shrink the tumor volume through the synergistic effect of local and systemic therapy, creating favorable conditions for surgery. Traditional interventional methods, such as TACE, can achieve local control by blocking tumor blood supply, while hepatic arterial infusion chemotherapy exhibits higher efficacy due to the optimal distribution of drug concentration. Postoperative adjuvant therapy mainly targets patients with high-risk factors for recurrence (such as microvascular invasion). Some studies have shown that the combination of targeted and immune therapy shows the potential to prolong the cycle of disease control and activate the immune response, whereas special attention should be paid to the risk of tumor progression during the treatment and the influence of adverse drug reactions on surgical resection. Targeted immunotherapy has gradually become the mainstream option. Clinical evidence shows that it may delay the recurrence time, but the long-term impact on recurrence rate remains to be investigated. Subsequently, it is necessary to combine with molecular markers (such as circulating tumor characteristics or immune microenvironment indexes) to achieve precise patient stratification, optimize the treatment cycle to balance efficacy and safety, and promote the establishment of a 'local-systemic-immune' full-cycle management mode.