Sonodynamic therapy (SDT) applies low-frequency ultrasound to activate sonosensitizers that have accumulated in tumor location, which induces cavitation effects and leads to the in-situ generation of reactive oxygen species (ROS), thereby achieving precise and efficient tumor treatment. Owing to its advantages such as deep tissue penetration and controllable treatment range, SDT has attracted significant attention and has been widely used in the research on the treatment of various tumors. While conventional treatment modalities have achieved significant efficacy in the treatment of hepatocellular carcinoma (HCC), there are still certain limitations. In this context, nanomedicine-based SDT leverages the targeting capabilities of nano-agents to realize specific killing of HCC cells, and furthermore, it can synergize with photodynamic therapy, chemotherapy, and immunotherapy to provide new opportunities for developing novel treatment modalities for HCC. This article reviews the mechanism of action of SDT and the advances in the research and application of SDT in the treatment of HCC, analyzes the shortcomings of existing studies, and proposes the directions for future development, in order to provide a theoretical foundation and scientific guidance for related research on HCC.