Background: Liver cancer is the fifth most common cancer worldwide and the third most common cause of cancer mortality. Hepatocellular carcinoma (HCC), which accounts for 80%-90% of primary liver cancer, is characterized by a very poor prognosis and is associated with high mortality. Current available therapeutic modalities for HCC such as resection, transplantation, local ablation or trans-arterial chemo-embolization are largely inadequate. There has been considerable interest to augment the immune responses against cancer by immunization. Dendritic cells (DCs) are the most potent antigen presenting cells and are unique in their ability to stimulate T cells and initiate adaptive immunity, DCs used as potential cellular adjuvants for the production of specific tumor vaccines. Objective: Evaluation of the efficacy of autologous pulsed dendritic cells on advanced HCC in comparison to supportive treatment.Methods: 30 patients with advanced HCC. Patients were divided into 2 groups: group I, 15 patients received dendritic cells vaccine and group II, 15 matched age & sex patients (control group), received only supportive treatment. All patients were followed up for six months by clinical assessment, liver function tests, CBC, kidney function tests, alpha fetoprotein, abdominal ultrasonography & triphasic CT. Results: There were partial response in 2 patients (13.4%), stationary course in 4 patients (26.6%) & progressive disease in 9 patients (60%) in group I treated by DC vaccination while in group II (control), there were stationary course in 2 patients (13.3%) & progressive course in 13 patients (86.6%) detected radiologically. The median survival time in group I patients receiving DC vaccine was 7 months, (with a mean value of 9.8 ± 7.8 months) compared to 4 months in group II (control) (with a mean value of 5.2± 2.6 months). Conclusion:Autologous DC vaccination in patients with advanced HCC is safe and well tolerated with some evidence of antitumor efficacy assessed radiologically and serologically, however further studies are needed to determine the best dosage regimen and route of administration. Also future trials in less advanced disease may be associated with even better clinical responses. In future, immunotherapy should probably be used as an adjuvant to radical therapy.