This paper is to discuss the clinical decision making of TCM treatment for primary liver cancer. It is believed that the combination of disease and syndrome differentiation is the basic principle of the treating, and the treatment is based on the clinical stage. Stress should be put on strengthening the body resistance in the early stage while eliminating pathogens is as subsidiary role. In the medium term stress should be put on eliminating pathogens and strengthening the body resistance is as subsidiary role. In the advanced stage, equal importance should be put on strengthening the body resistance and eliminating pathogens and external treatment should be used to alleviate sufferings at the end stage.