Objective: To investigate the changes in serum transforming growth factor β1 (TGF-β1) level in patients with advanced primary hepatic carcinoma (PHC) before and after transcatheter arterial chemoembolization (TACE) and its prognostic significance. Methods: One-hundred and sixteen patients with advanced PHC undergoing TACE in the People’s Hospital of Zhengzhou from June 2012 to January 2016 were enrolled. The serum TGF-β1 levels of the patients were determined at 1 d before and 1, 7 and 30 d after TACE. The relations of serum TGF-β1 level with recurrence/metastasis and survival time of the patients were analyzed according to the follow-up findings and TGF-β1 level at each defined time point. Results: In the entire group of patients, the TGF-β1 level was significantly higher at 1 d after TACE, while it was significantly lower at 7 or 30 d after TACE than that of preoperative value (all P<0.05); the TGF-β1 level in patients with postoperative recurrence/metastasis (75 cases) showed no significant difference with that in patients with progression-free survival (41 cases) at either preoperative or postoperative 1 or 7 d assessment (all P>0.05), but was significantly higher than that in patients with progression-free survival 30 d after TACE (268.3 pg/mL vs. 200.4 pg/mL, P=0.001). The results of Kaplan-Meier analysis showed that the TGF-β1 level before and 30 d after TACE along with the maximum diameter of the tumor and lesion number were the influential factors for survival time of the patients (all P<0.05), and the results of multivariate Cox regression analysis showed that the postoperative 30 d TGF-β1 level (OR=2.820, 95% CI=1.559–5.102, P=0.001) together with the maximum diameter of the tumor (OR=2.063, 95% CI=1.152–3.694, P=0.015) were the independent prognostic factors. Conclusion: The change in TGF-β1 level is closely related to the outcomes of patients with advanced PHC after TACE. The preoperative and postoperative day 30 TGF-β1 levels have certain implications for prognosis, and patients with high TGF-β1 level may have a higher risk of poor prognosis than those with low TGF-β1 level.