Abstract: Objective To investigate the necessity of prophylactic administration of antibiotic in patients with primary liver cancer undergoing transcatheter arterial chemoembolization (TACE). Methods Sixty patients without preoperative infection were randomized into two groups to receive a single dose of cefazolin (PA group) prior to TACE or no prophylactic antibiotics (NONE group). The incidence of postoperative infection was compared. Results The incidence of postoperative infection was 3.4% (1/29) in NONE group and 3.2% (1/31) in PA group, without significant difference between the two groups (P>0.05). Conclusion Prophylactic antibiotics are not necessary for patients with primary liver cancer prior to TACE.