Primary hepatocellular carcinoma (HCC) represents a malignancy of notable clinical concern, marked by elevated global incidence and mortality rates. Despite advancements in therapeutic modalities, HCC management remains challenged by the insidious onset of early-stage disease and the limited efficacy of late-stage surgical interventions. Transcatheter arterial chemoembolization (TACE) has evolved as a pivotal intervention for HCC, with recent innovations fostering synergistic combination strategies to augment therapeutic outcomes. Synthesizing contemporary clinical evidence and anticipating future advancements in TACE-based multimodal approaches is imperative to refine therapeutic paradigms and optimize patient prognoses. The present review critically evaluates the current landscape of TACE-centered multimodal therapies and explores emerging innovations poised to redefine therapeutic frontiers in HCC management.