Objective:To evaluate the treatment efficacy and the necessity of radiofrequency ablation (RFA) followed by transarterial chemoembolization (TACE) for patients with unresectable primary liver cancer (PLC).Methods :From April, 2004 to January, 2008, 65 patients with unresectable PLCs underwent TACE after RFA. Fifty＆four cases were male, and 11 female. The maximum diameter of the tumor was 1.5 cm to 10 cm. Fourteen tumors were small (≤3 cm), 17 were medium (3.1–5.0 cm) and 34 were large (＞5cm) or multinodular (≥3 nodules). The liver function (ChildPugh) was class A in 51 cases, and class B in 14 cases. Fiftyeight cases were hepatocellular carcinoma and the other 14 cases were cholangiocarcinoma. RFA was performed by a RITA expandable electrodes device and followed by TACE using Seldinger′s technique. RFA response was evaluated with computed tomography performed one month after RFA, and then treatment efficacy was evaluated by observation of surviral.Results:Classified by RFA response, patients received complete ablation in 24 cases, nearly ablation in 15 cases and partial ablation in 26 cases. The treatment efficacy of RFA plus TACE was curative in 22 cases, subcurative in 13 cases and palliative in 26 cases. The relationships between RFA response and treatment efficacy were significantly correlated (r=0.877，P＜0.001). The total survival rate after RFA plus TACE at 1, 2 and 3year was 78.2%, 65.3% and 44.0%, respectively. The 3year survival rate for patients who received complete ablation, nearly ablation and partial ablation was 73.5%，45.0% and 0.0%, respectively. The smaller the tumor, the more complete was the tumor ablated, and the results were better.Conclusions:TACE following RFA has therapentic effect and is nccessary for patients with medium or large PLC to eradicate residual tumor and micrometastasis.