Background: Hepatocellular carcinoma (HCC) is a prevalent and highly lethal form of cancer that has shown significant progress in treatment modalities in recent times. The Systemic therapy for HCC has changed since the introduction of the molecular targeted agent sorafenib in 2007.. This study aimed at assessment of the outcome of patients with HCC receiving systemic therapy for three months. Methods: This prospective observational study was conducted among HCC Patients who attending the outpatient clinic at Hepatology and gastroenterology Minia University Hospital from January 2023 to December 2023. 110 patients diagnosed with HCC who were categorized as BCLC B-C and underwent systemic therapy were included in the study. Results: mean age of HCC patients was 45.5 ± 15.8., About 77% were male, 69% were rural residents and 91% were HCV positive, all patients were child score type A and 98% were in sorafenib. There is statistically significant difference in number of focal lesion before and after treatment. (p value <0.05) as 32% of HCC patients had multiple focal lesion before treatment and become 22.7% after treatment. Regarding outcome of HCC patients within 3 months of follow up, about 14.5% died after 3 months and also 14.5 stopped treatment due to complication and the remaining 71% continued treatment. Regarding course of disease, about 47% had progressive course, 23.5% had regressive course while only 29% had stationary course. Conclusions: individuals who have been diagnosed with advanced stage hepatocellular carcinoma (HCC) experience positive outcomes from sorafenib.hepatocellular carcinoma (HCC) experience positive outcomes from sorafenib.