Objective: To explore the effect of transarterial chemoembolization (TACE) + CT-guided microwave ablation (MWA) on treating patients with primary liver cancer. Methods: 78 primary liver cancer cases were enrolled and divided into groups according to their assigned surgical plans. The control group was treated with TACE alone, and the observation group was treated with TACE + CT-guided MWA. The efficacy of the treatment and the liver function indicators and follow-up results of the patients of the two groups were compared. Results: The efficacy of the treatment received by the observation group was higher than that of the control group. Besides, the patients in the observation group exhibited better improvement in liver function indicators after 3 months of treatment. Furthermore, the survival rates of 1 and 2 years after surgery of the observation group were all higher than those of the control group (P < 0.05). Conclusion: TACE combined with CT-guided MWA is more effective in treating primary liver cancer compared to TACE alone. Besides, it resulted in better improvement of liver function and long-term survival rate. Therefore, this treatment regime should be popularized.