The pathogenesis of hepatocellular carcinoma （HCC） involves inflammation and liver fibrosis caused by chronic liver injury， leading to the abnormal proliferation and mutation of liver stem cells and the formation of tumor cells. Although great progress has been made in Western medicine treatment of HCC， the 5-year survival rate of patients remains below 20%， with the limitations such as strong drug resistance and adverse reactions. In recent years， traditional Chinese medicine （TCM） has gradually gained attention in the field of antitumor therapy due to its unique advantages of regulating tumor microenvironment and signaling pathways through multiple components and targets. The Hedgehog signaling pathway plays an important role in cell proliferation， differentiation， and tumor metastasis， and its role in the development and progression of liver cancer has attracted more and more attention. This article reviews the mechanisms and research advances in the anti-HCC effect of TCM monomers and compound prescriptions through targeted regulation of the Hedgehog signaling pathway， in order to provide new ideas for TCM prevention and treatment of HCC.