Hepatocellular carcinoma (HCC) causes approximately one million deaths every year. Due to advanced stage at diagnosis, HCC carries a five-year survival rate of less than 5%, if diagnosed with unresectable disease. And also HCC is responsible for significant morbidity and mortality in cirrhosis. It leads to decompensation of cirrhosis and is the cause of death in up to 25% of cirrhotic patients. The purpose of this article is to provide an overview of the complexity in complication management of patients with terminal stage of HCC. The occurrence of complications in HCC patients is common, and includes portal hypertension, ascites, and variceal bleedings. Because of the limitations in the efficacy of current treatment options for terminal stage HCC, complication management is a key to preserving physical functioning and quality of life in these patients. Until now, diuretics remain the gold standard in management of ascites in cancer patients, and endoscopic treatment and vasoconstrictor are good choice for acute variceal bleedings. In several studies, sorafenib showed a potential as therapeutics for portal hypertension in patients with advanced HCC.