This study aims to investigate the efficacy of adjuvant transarterial chemoembolization (TACE) with or without antiviral therapy for patients with hepatocellular carcinoma (HCC) after radical hepatectomy. This retrospective study examined 176 patients after radical hepatectomy, 118 of whom were treated using TACE alone and 58 using TACE combined with antiviral therapy. To reduce confounding bias due to baseline differences, propensity score matching was used to generate 51 pairs of patients from both treatment groups. Overall survival (OS) and disease-free survival (DFS) were analyzed for both groups before and after propensity score matching. Analysis of all patients showed that OS was better in the combination therapy group than in the TACE-only group (P = 0.048), while DFS was similar between the two groups (P = 0.322). Analysis of only propensity score-matched pairs confirmed the significantly better 5-year OS in the combination therapy group (64.6 vs. 37.5 %, P = 0.033) and also suggested better 5-year DFS (37.9 vs. 14.6 %, P = 0.048). Among patients experiencing HCC recurrence, radical surgery was the treatment choice for a significantly larger proportion of patients from the combination therapy group than from the TACE-only group (P = 0.018). Our results suggest that combining antiviral therapy with TACE significantly improves OS and potentially DFS relative to TACE alone in patients with HCC. Combination therapy also appears to leave patients with greater remnant liver function, increasing the possibility of curative resection in the event of recurrence. Combination therapy may be useful for preventing HCC recurrence after radical hepatectomy.