Hepatic Sarcomatoid Carcinoma (HSC), a rare subtype of liver cancer, contains a mixture of cancerous and sarcomatous components. The disease is prone to metastasis and has a poor prognosis. This study reports the case of a 67-year-old male patient admitted to our hospital because of a right liver mass found on a physical ultrasound examination. There was no abdominal tenderness or rebound tenderness; Laboratory tests on admission showed increased HBV and alpha-fetoprotein (AFP); Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) showed a mass in the SV segment of the liver, suggesting Hepatic Cell Carcinoma (HCC) with multiple hilar and retroperitoneal lymph node metastases, and multiple lung metastases. The patient underwent a liver tumour biopsy, and immunohistochemical detection of cytokeratin (CK) and vimentin (Vim) was positive. The pathological diagnosis was HSC. The preferred treatment for HSC is surgical resection; however, considering the presence of systemic metastases in this patient, systemic treatment (Targeted therapy + Immunotherapy + Chemotherapy) is the primary treatment supplemented by local interventional treatment. At 1-year follow-up, mRECIST evaluated as PR, and PFS was not achieved. For patients with advanced hepatic Sarcomatoid carcinoma, local treatment should be combined with systemic treatment, and individualized management should be implemented to prolong the survival period of patients as much as possible and improve the quality of life of patients.