Abstract: Primary liver cancer is a type of malignant tumor in the digestive system with high incidence and mortality rates. Hepatocellular carcinoma accounts for approximately 80% of primary liver cancer. Radical surgical resection or liver transplantation is the primary curative option for patients with hepatocellular carcinoma. However, due to the high invasiveness and metastatic nature of hepatocellular carcinoma, the five‑year recurrence rate remains high even after radical resection. For recurrent hepatocellular carcinoma after surgery, the current clinical treatment methods mainly include re‑surgical resection, ablation, interventional therapy, and systemic treatment, etc. However, for patients with hepatocellular carcinoma who cannot undergo re‑surgery due to insuffi-cient residual liver volume and for those with recurrent hepatocellular carcinoma without re‑surgery indications, non‑surgical treatment methods such as ablation therapy, targeted therapy, and immune therapy are increasingly being used in the clinical application. In recent years, studies have shown that microwave ablation combined with immune checkpoint inhibitors has a synergistic anti‑tumor effect. However, the current domestic and international guidelines have not recommended this combined treatment regimen for the treatment of postoperative recurrent hepatocellular carcinoma. The authors review the mechanism of action and clinical research progress of microwave ablation combined with immune therapy for postoperative recurrent hepatocellular carcinoma, with the aim of providing better treatment strategies for postoperative recurrent hepatocellular carcinoma.