Bone metastases in hepatocellular carcinoma (HCC) are usually treated with non-operative procedures such as radiotherapy, hormonal therapy, bisphosphonates, or sometimes with surgical procedures. Here we describe a case with 3rd cervical spine metastasis of HCC. A 62-year-old female with liver cirrhosis presented with neck pain. After evaluation, the patient was diagnosed of hepatocellular carcinoma with cervical spine metastasis. The metastatic lesion was treated with tomotherapy while the primary lesion in the liver was treated with transarterial chemoembolization using drug-eluting beads, and the patient is tolerable waiting for the next treatment.