Abstract: Hepatocellular carcinoma (HCC) is a common malignant tumor with high incidence and mortality rates globally. The wide tumor heterogeneity and high likelihood of metastasis of HCC contribute to its poor prognosis, and the treatment options for HCC remain limited. Radical hepatectomy and liver transplantation remain the preferred treatment strategies for resectable HCC; reducing the postoperative recurrence rate of HCC is key to improving patient outcomes. Considerable progress has been achieved in treating unresectable HCC with the combined application of local and systemic therapies such as targeted therapy, immunotherapy, radiotherapy, and interventional therapy. The treatment strategies for neoadjuvant therapy for resectable HCC, which has a high risk of recurrence, may be selected based on individualized principles. Systemic therapies (targeted therapy and immunotherapy) or local therapies (transcatheter arterial chemoembolization, TACE, and hepatic arterial infusion chemotherapy, HAIC) may be chosen. The safety, efficacy, invasiveness, and accessibility of these neoadjuvant regimens must be comprehensively evaluated, while optimizing the timing of subsequent surgery. Therefore, future research should focus on neoadjuvant therapy to improve the prognosis of patients with resectable HCC with a high risk of recurrence.