Objective: To investigate the relationship between digital subtraction angiography (DSA) findings and efficacy of transcatheter arterial chemoembolization (TACE) therapy in primary liver cancer. Methods: Sixty-one patients with primary liver cancer undergoing DSA examination and TACE therapy from April 2012 to April 2014 were selected. According to the intraoperative DSA findings, the patients were divided into rich blood supply group (44 cases) and moderate blood supply group (17cases). Postoperative followed-up was conducted for 3 months to 2 years, the therapeutic response was assessed by mRECIST criteria, and the relations of DSA blood supply group of the tumor with the response and prognosis of the patients were analyzed. Results: Two months after TACE, in rich blood supply group, complete response (CR), partial response (PR), stable disease (SD), and progressive disease (PD) was found in 2 cases (4.5%), 29 cases (65.9%), 6 cases (13.6%) and 7 cases (8.6%), and the objective response rate (CR+PR) was 70.4%, and disease control rate (CR+PR+SD) was 84.0%, respectively; in moderate blood supply group, CR, PR, SD and PD was 0 case (0.0%), 5 cases (29.4%), 4 cases (23.5%) and 8 cases (47.1%), and the objective response rate and disease control rate was 29.4% and 52.9%, respectively. For rich blood supply group and moderate blood supply group, the median survival time was 14 and 7.9 months, and the accumulated 6-, 12- and 24-month survival rate was 91.0%, 68.2% and 20.4%, and 59.1%, 23.0% and 12.1%, respectively, and the differences had statistical significance (all P<0.05). Conclusion: For primary liver cancer, the DSA blood supply classification is closely related to the efficacy of conventional TACE therapy, and cases with rich blood supply may have a better response to TACE treatment.