Objective: The objectives of this study were to evaluate the long-term results with multimodality therapy, and to clarify the clinicopathologic of features of patients surviving ≥ 3 years for unresectable hepatocellular carcinoma (HCC).Methods: Between 1999 and 2003, a total of 166 patients underwent multimodality therapy for unresectable HCC. All patients underwent multimodality therapy, such as transarterial chemoembolization (TACE), chemotherapy, local ablative therapy, and/ or Chinese traditional medicine. Thirty-nine (23.5%) patients survival > 1 years, and 10 (6.0%) patients survived-> 3 years. These 39 patients surviving over 1 year were investigated in this study. Eighteen clinical and biologic variables were assessed using univariate and multivariate analyses. Results: TNM staging and tumor extension were isolated by univariate analysis. Only tumor extension was independent risk factors by multiple regression analysis. Of these, 25.6% (10 of 39) survived over 3 years. These 10 patients surviving over 3 years were investigated further. By the end of June 2004, follow-up varied from 3 years and 2 months to 5 years and 1 month. Six patients were still alive with free of disease. Conclusion: Tumor extension was demonstrated to be prognostic of long-term survivors. Multimodality therapy may make a major contribution to achieving long-term survival in patients with unresectable HCC.