In recent years, thanks to the development of radiation therapy techniques and the update of radiation therapy equipment, external beam radiation therapy has been applied in all stages of hepatocellular carcinoma (HCC). In 2009, external beam radiation therapy was recommended as one of the treatment options for HCC by the National Comprehensive Cancer Network (NCCN) Guidelines. The 2018 NCCN Guidelines clearly state that three-dimensional conformal radiation therapy, intensity-modulated radiation therapy, or stereotactic body radiation therapy (SBRT) are all applicable regardless of the location of the tumor. The 2019 NCCN Guidelines further recommend image-guided radiation therapy in the treatment of HCC. Chinese Society of Clinical Oncology Guidelines for the Diagnosis and Treatment of Primary Liver Cancer also recommend SBRT for the treatment of early-stage small HCC, and local radiation therapy combined with TACE for the treatment of intermediate HCC and extrahepatic metastases, according to different levels of evidence.