Objective To identify the survival benefits and safety of transarterial chernoembolization (TACE) combined with sorafenib for intermediate-advanced hepatocellular carcinoma (HCC) compared with those of TACE alone.Methods Randomized-controlled trials (RCTs) and non-randomized controlled clinical trials (CCTs) published as full texts were searched to assess the survival benefits or safety for patients with intermediate-advanced HCC on electronic databases as well as manual searches.We pooled odds ratios (ORs) with 95% confidence intervals (Cls) to estimate the results.Results A total of 12 eligible trials (including 1511 patients) were finally enrolled which came from various medical centers.Meta-analysis showed that TACE combined with sorafenib group,respectively improved 6-month and 1-year overall survival compared with that of TACE alone [(OR =2.50,95% CI =1.70-3.67; P < 0.00001) and (OR =2.49,95% CI =1.90-3.27; P < 0.00001)].Similarly,the pooled analysis revealed that compared with TACE group,TACE plus sorafenib group significantly improved overall response and disease control rate [(OR =2.00,95% CI =1.41-2.84; P =0.0001)) and (OR =2.48,95% CI =1.84-3.36; P < 0.00001) respectively].In addition,the analysis of adverse effects such as hand-foot skin reaction,diarrhea and hypertension were OR =45.92 (95% CI =17.87-117.99),OR =7.71 (95% CI =3.35-17.73) and OR =7.10 (95% CI =3.04-16.60) respectively.However,most of the adverse effects were relieved after additional prevention,treatment and dose adjustment of sorafenib.Conclusions TACE combined with sorafenib were more therapeutically beneficial and generally well tolerated for intermediate-advanced HCC.However,considering the strength of the evidence,additional large scale of researches and RCTs are still needed.