Sarcomatoid hepatocellular carcinoma (SHC) is a rare and highly aggressive variant of hepatocellular carcinoma (HCC), characterized by high malignancy, frequent recurrence, and poor prognosis. Definitive diagnosis is based on histopathological criteria to differentiate it from HCC and other malignant tumors in the liver. At present, there is no standardized treatment; surgery remains the primary therapeutic option, while other treatments show only modest effectiveness. We herein present a clinical case of a male patient diagnosed with SHC who experienced multiple recurrences and underwent multimodal treatment, including transarterial chemoembolization, surgery, and systemic chemotherapy.