Objective To observe the prognostic impact of portal vein immunochemotherapy in patients after resection of primary hepatocellular carcinoma (HCC) . Methods A retrospective analysis was performed on the clinical data of 48 patients who received portal vein immunochemotherapy after resection of primary HCC (immunochemotherapy group) and 59 patients who did not receive portal vein immunochemotherapy after resection of primary HCC (control group) . Continuous data were analyzed by two- sample t- test; rates were compared withχ2test. Survival analysis was performed by the Kaplan- Meirer method for calculating the mean survival time; the survival differences between the two groups were analyzed with the log- rank test. The prognostic factors in all the 107 patients were analyzed using a multivariate Cox regression model. Results The 1-, 2-, and 3- year disease- free survival (DFS) rates of the immunochemotherapy group and control group were 87. 5% (42 /48) vs 67. 8% (40 /59) (χ2= 5. 739, P = 0. 017) , 52. 1% (25 /48) vs 32. 2% (19 /59) (χ2= 4. 320, P =0. 038) , and 16. 7% (8 /48) vs 10. 2% (6 /59) (χ2= 0. 982, P = 0. 322) , respectively, and the mean survival time of the two groups was32. 4 ± 2. 3 months vs 24. 7 ± 2. 3 months (χ2= 4. 044, P = 0. 044) . Among the cases complicated by portal vein tumor thrombosis, those receiving postoperative portal vein immunochemotherapy had a mean survival time of 12. 4 ± 1. 3 months, versus 4. 8 ± 0. 4 months for those not receiving postoperative portal vein immunochemotherapy (χ2= 15. 535, P < 0. 001) . Cox regression analysis revealed that pathological differentiation, tumor size, liver function grade, and portal vein tumor thrombus were independent prognostic factors for the recurrence in patients after resection of primary HCC. Whether to receive portal vein immunochemotherapy is related to postoperative recurrence time (P < 0. 001) .Conclusion Portal vein immunochemotherapy could improve the DFS rate and survival time in patients after resection of primary HCC.