Abstract: Hepatocellular carcinoma (HCC) is a common therioma of digestive system. The occurrence of HCC involves many aspects, such as environment, metabolism and genetic factors. In recent years, it has been found that intestinal flora imbalance is also an important factor in the occurrence of HCC. When intestinal flora disorders occur, the intestinal mucosal barrier can be destroyed, bacterial translocation and endotoxemia can cause chronic inflammatory response of hepatocytes. Long-term and chronic changes of intestinal flora metabolites such as short-chain fatty acids and bile acids also play a role in promoting HCC. At present, a variety of methods to improve intestinal flora disorders have shown a bright future in the treatment of HCC. This article reviews the mechanisms of intestinal flora-induced HCC and the preventive and therapeutic measures against intestinal flora imbalance.