Lenvatinib, a multi-target tyrosine kinase inhibitor (TKI), is definitely an emerging first-line therapy for hepatocellular carcinoma (HCC). Its application has altered the status of sorafenib because the only first-line TKI strategy to HCC for over a decade. Evidence has proven that lenvatinib offers antitumor proliferation and immunomodulatory activity in preclinical studies. Compared, lenvatinib was non-inferior to sorafenib in overall survival (OS), as well as shows brilliance regarding all of the secondary effectiveness endpoints. Immune-checkpoint inhibitors(ICIs)are increasingly being integrated into HCC treatment. Positive outcomes happen to be achieved within the mixture of lenvatinib plus ICIs, getting broader prospects for HCC. This review presents a summary around the therapeutic mechanisms and clinical effectiveness of lenvatinib in HCC, so we discuss the long run perspectives of lenvatinib in HCC management with concentrate on biomarker-led precision medicine.