Simple Summary Hepatocellular carcinoma remains a serious disease for which curative treatment is only available for about 20% of patients. Because of the severity of the disease and the modest benefit of treatment, quality of life is of paramount importance, especially as its impact on the prognosis of the disease has been demonstrated. Systemic treatments have specific side effects for which close monitoring and symptomatic management improve quality of life. Quality of life (QoL) in oncology is an outcome becoming more and more important and relevant to explore. Some studies have demonstrated its prognostic impact in different cancers, such as colorectal, breast, and prostate cancers, but also in hepatocellular carcinoma (HCC). Different tools have been developed for assessing quality of life, some general, such as EORTC QLQ-C30, but also specific tools depending on cancer origin which seem to be more pertinent for patients. Systemic treatments and specific symptoms due to cancer evolution could decrease quality of life. For approval of new systemic treatments, authorities ask for benefit in terms of efficacy but also benefit in quality of life, which is crucial for patients. This review reports data about QoL in HCC, including specific tools used, impact of systemic treatments and prognosis for QoL for HCC patients. Management of adverse events is essential to enhance compliance with treatment and quality of life. Assessing quality of life in clinical trials appears quite systematic, but its application in clinical routine requires development.