Abstract: Objective To investigate the effect of arsenic trioxide (As2O3) in treatment of advanced primary liver carcinoma (PLC). Methods Total of 48 cases of advanced PLC were randomly divided into the treatment group (26 cases) and control group (22 cases). The two groups received basic hepatoprotective, antiviral, symptomatic of the treatment group was added with As2O3 10 mg, 10% glucose injection 500 ml, intravenous drip once a day, every two weeks for one courses, two weeks apart, for a course of treatment, a total of two courses. An observation is checked and curative effect evaluation. Results The two groups of patients were observed at the end of the objective efficiency, benefit rate were 0%, 19.2% and 22.8% (P = 0.0376), 53.8% (P = 0.0083), two groups of patients and improve quality of life, stable rate were 31.8% and 65.4% (P = 0.0291). Conclusions As2O3 treatment has a certain clinical value for advanced PLC, liver function is poor, unable to tolerate other treatment of patients with PLC, As2O3 is a more effective treatment.