ObjectiveTo summarize the comprehensive multidisciplinary team (MDT) treatment and holistic scientific management approach in a case of hepatocellular carcinoma (HCC) in S7+S9 segments with prostatic metastasis. MethodsA retrospective analysis was conducted on the clinical data and follow-up outcomes of a patient with HCC in S7+S9 segments who developed prostatic metastasis during treatment, admitted to the Tenth Affiliated Hospital of Southern Medical University (Dongguan People’s Hospital of Guangdong Province). ResultsDue to the complexity of the patient’s condition, an MDT discussion was held upon initial admission. It was concluded that the HCC diagnosis was clear, with lesions confined to the liver (S7+S9 segments) and a tumor diameter less than 3 cm, making surgical resection or ablation therapy the preferred options. However, the patient declined liver transplantation and surgical resection. Therefore, CT-guided microwave ablation (MWA) was performed on the primary HCC lesions in segments S7 and S9b. Prior to subsequent treatments for recurrent disease, MDT discussions were held again, and treatments were tailored to the discussion outcomes while respecting the patient’s wishes. Over time, the patient underwent CT-guided liver puncture MWA, re-ablation for recurrent tumors, transarterial chemoembolization (TACE), stereotactic body radiation therapy (SBRT), targeted therapy, and immunotherapy. Following this comprehensive MDT treatment plan, the patient had survived for over 78 months, with no evidence of active tumor lesions in the liver, prostate, or other parts of the body. Alpha-fetoprotein levels and liver function remained normal, and the patient’s quality of life was good. ConclusionComprehensive MDT treatment incorporates various technologies and approaches, along with holistic scientific management, can yield favorable outcomes for patients with complex and challenging HCC.