Hepatic carcinoma (HCC) is the sixth most common malignant tumor in the world and the third leading cause of death. Due to the hidden nature of onset of HCC, most patients are already at the intermediate or advanced stage at the time of diagnosis and are not candidates for curative surgical treatment. Sorafenib, as a molecular targeted drug against angiogenesis, has opened the door of molecular targeted therapy for HCC since 2007, systemic treatment has become one of the hotspots in the treatment of HCC. In the following decade, targeted drugs for HCC developed, such as regorafenib, levovirinib, cabozantinib, remollozumab and some immune checkpoint inhibitors, and they have achieved good results in phase III clinical trials. This review describes the current status of anti-vascular molecular targeted therapy and immunosuppressive agents in the treatment of HCC, the challenges to be solved and the possible future development.