【Abstract】 Objective To observe the clinical efficacy in patients with middleadvanced primary liver cancer treated with TACE combined with apatinib. Methods 42 patients with the middleadvanced primary liver cancer were divided into the treatment group (apatinib combined with TACE) and the control group (sorafenib combined with TACE). The clinical efficacy, the expression of AFP and adverse reactions were observed. Results No statiscally significant differences were found in ORR, DCR and 1 year survival rate between the two groups (P＞005). The adverse reactions including hypertension, skin mucosal reaction in the treatment group were higher than those in the control group (P＜005). The adverse reactions were relieved after symptomatic treatment. The descent range of AFP 3 month after treatment of the two group was higher than that before treatment (P＜005). While no statistic differences were obtained in the descent range of AFP between the treatment group and the control group (P＞005).Conclusion Apatinib combined with TACE in the treatment of liver cancer is helpful to improve the DCR and decrease the expression of AFP. The clinical efficacy is not inferior to Sorafenib combined with TACE, and it is a good choice for treatment of middleadvanced primary liver cancer.