Objective To study clinical efficacy of irreversible electroporation in the treatment of advanced hepatic carcinoma. Methods Between July 2015 and September 2015, 8 patients with advanced hepatic carcinoma (10 tumors) were treated by ultrasound-guided irreversible electroporation, using pertacuneous, laparoscope or open surgery in the Rockets Army General Hospital of PLA. Prospectively collected and summarized the clinical data. Finally, analyzed the therapeutic effect of irreversible electroporation. Results Compared with before treatment, the quality of life score significantly increased 〔(37.75±4.65) scores vs. (22.25±2.87) scores, P=0.000〕 in 3 months after treatment of irreversible electroporation, but value of serum total bilirubin (56.37 mmol/L vs. 150.40 mmol/L, P=0.046), direct bilirubin (58.69 mmol/L vs. 71.60 mmol/L, P=0.012), alanine aminotransferase 〔(52.63±12.14) U/mL vs. (87.28±27.94) U/mL, P=0.003〕, asperate aminotransferase 〔(48.45±13.75) U/mL vs. (74.40±21.09) U/mL, P=0.000〕, and alpha fetoprotein (82.10 ng/mL vs. 159.20 ng/mL, P=0.042) significantly decreased. One patient suffered from persistent upper abdominal pain after irreversible electroporation, but no serious complications, such as infection, biliary fistula, hemorrhage, and liver or kidney failure occurred in all 8 patients. Abdominal enhanced CT scanning or MRI in 3 months after irreversible electroporation showed complete ablation in 7 patients and incomplete ablation with some residual in 1 patient. Eight patients were followed up for 3-5 months 〔an average of (4.0±0.9) months〕. During follow-up period, all patients had been alive with 1 case of recurrence. Conclusion The effect of ultrasound-guided irreversible electroporation in the treatment of advanced hepatic carcinoma is remarkable, and it may deserve clinical application in consideration of its safety and efficacy.