Hepatocellular carcinoma (HCC) still has a poor clinical prognosis, mainly due to its insidious onset, and most patients have reached an advanced stage at initial diagnosis and lost the indications for surgery. With the combined application of multidimensional therapeutic options such as novel targeted drugs, immune drugs and local therapies, the objective response rate of HCC has greatly improved, laying a foundation for conversion therapy. Conversion therapy is a major breakthrough for the treatment of HCC lately, and it aims to make unresectable tumors resectable, and has now become an effective treatment for unresectable HCC. However, conversion therapy of HCC still faces many challenges. The paper provides an in-depth description of the strategies and efficacy of conversion therapy for HCC based on the authors’ clinical experience and the latest advances in this field.