〔Abstract〕 Objective To explore the short-term effect of Stereotactic Body Radiation Therapy (SBRT) for hepatocellular carcinoma (HCC) combined with portal vein tumor thrombus (PVTT). Methods A retrospective analysis of 18 patients with primary HCC combined with PVTT admitted to the First Affiliated Hospital of Xiamen University from April 2020 to January 2021 was carried out. SBRT was performed for PVTT, and PVTT withdrawal rate after radiotherapy and adverse reactions related to radiotherapy was observed. Results All patients completed the course of radiotherapy. 4 weeks after radiotherapy, the efficacy was evaluated in 1 case with complete remission, 3 cases with partial remission, 13 cases with stable disease, and 1 case with disease progression. Acute injury during radiotherapy was tolerable, and no upper gastrointestinal bleeding or radiation liver disease was found in the follow-up after radiotherapy. Conclusion SBRT can be used as a safe and effective treatment for HCC combined with PVTT.