The mechanism of competitive endogenous RNA (ceRNA) regulation in the occurrence and development of hepatocellular carcinoma (HCC) was reviewed and the relationship between TCM treatment of HCC and the regulation of ceRNA was discussed. The regulation of ceRNA takes miRNA as the core. Under the action of miRNA response element (MRE), Mrna, pseudogene transcripts, lncRNA, circRNA and others competitively combine with miRNA to form a ceRNA regulatory network. The regulation pattern of ceRNA plays an important role in the occurrence, development, metastasis and invasion of tumors. The research on the mechanism of ceRNA regulating HCC can improve the accuracy of targeted prediction and effectively screen potential therapeutic targets and prognostic biomarkers while at present it is still at the exploratory stage. The regulation mechanism of ceRNA is also an important regulation method of TCM in the treatment of HCC. The intervention of active ingredients of traditional Chinese medicine has a very broad prospect in the field of tumor treatment, and the study of the anti-tumor mechanism of traditional Chinese medicine based on ceRNA regulation also provides new research directions for the diagnosis and treatment of tumor.