Objective To study the clinical value of combined detection of the serum levels of AFP, CA125, CA199 and CEA in the diagnosis of primary hepatic carcinoma (PHC). Methods Serum levels of AFP, CA125, CA199 and CEA in 68 patients with PHC, 50 patients with benign liver disease and 58 normal controls were measured by Electrochemiluminescence immuno-assay (ECLIA). Results The levels of AFP, CA125, CA199 and CEA in PHC group were significantly higher than those in benign liver disease and normal controls. Sensitivities of AFP, CA125, CA199 and CEA were 76.4 %, 35.3 %, 44.1%, 29.4 %, respectively. Sensitivity of combined detection of four kinds tumor markets was 94.1%. Conclusion Combined detection of four kinds of serum tumor markers is useful to increase the detective positive rate in the diagnosis of PHC.