Background: Portal vein thrombosis is considered a relative contraindication for transarterial chemoembolization (TACE) in hepatocellular carcinoma. The purpose of our study was to evaluate the efficacy of TACE treatment in patients with hepatocellular carcinoma with portal vein (PV) thrombosis. Material and Methods: HCC patients reporting to our hospital (2001-2007) were subjected to clinical, biochemical, and radiological examination. TACE was performed in those who fulfilled the inclusion criteria. Follow-up assessment was done with multiphase CT scan of the liver at 1, 3, and 6 months. Tumor response and survival rate were estimated. Univariate and multivariate analyses were done for determinants of survival. Results: Out of 90 patients included in the study; 49 were male (56.3%) and remaining 41 were female (45.1%). Their mean age was 57 years (range 16–74 years). DWI was performed on 93 (82.4%) patients. Patients were assessed for tumor response by imaging at regular intervals and the data compared with the baseline laboratory and imaging characteristics obtained before treatment. Univariate analysis was used to assess the treatments impact on patient survival. Survival analysis was performed using Kaplan–Meier estimations. Conclusion:TACE offers a reasonable palliative therapy for HCC. Initial tumor size is an independent predictor of survival.