Hepatocellular carcinoma (HCC) is the fourth leading cause of cancer death in the world, and its prognosis is poor. Most HCC patients are diagnosed at an advance stage and are not candidates for surgery. Even if the early-stage tumor is resected, HCC patients tend to relapse within 5 years. In the era of targeted therapy and immunotherapy, neoadjuvant therapy has gained increasing attention and recommendation. For HCC patients with high recurrence risk, neoadjuvant therapy refers to preoperative local or systemic therapy, which can reduce tumor burden, remove tiny lesions, widen surgical margin, and reduce the recurrence risk. However, if the neoadjuvant therapy is not optimal, the timing of surgery will be delayed, resulting in disease progression or even loss of the chance for surgery. This article reviews the research progress of neoadjuvant therapy for HCC.