Hepatocellular carcinoma (HCC) with portal vein tumor throm- bus (PVTT) yields poor prognosis with a median overall survival (OS) of 2.7–4 months [1] . Once PVTT develops in the main portal vein, the sudden appearance of portal hypertension often leads to fatal complications, including esophagogastric variceal hemorrhage, refractory ascites, and liver failure. Transarterial chemoemboliza- tion (TACE) has been recommended for advanced HCC patients by China Liver Cancer Group due to its benefit of OS compared with using sorafenib alone [2] . For the treatment of PVTT, portal stent with endovascular iodine-125 brachytherapy (PSEIB) was re- cently reported to be effective because it relieved portal hyper- tension rapidly and controlled PVTT effectively with an improved OS of 9.3–12.5 months [3 , 4] . The combination of PSEIB and TACE had been applied in some studies [3 , 4] . Nevertheless, these studies failed to demonstrate the effect of PSEIB on TACE results. Herein we aimed to present a case how PSEIB improves the efficacy of TACE for HCC patients with main PVTT.