In patients with unresectable hepatocellular carcinoma (HCC), the combination of atezolizumab (an immune checkpoint inhibitor) and bevacizumab (antibody against VEGF) led to better overall and progression-free survival than sorafenib. The open-label, phase III trial included 336 patients in the atezolizumab–bevacizumab group and 165 patients in the sorafenib group. At the primary analysis, the hazard ratio for death with the combination therapy versus sorafenib was 0.58 (95% CI 0.42–0.79; P < 0.001). Overall survival at 12 months was 67.2% with atezolizumab–bevacizumab and 54.6% with sorafenib. Moreover, median progression-free survival was longer in the combination therapy group (6.8 months) than the sorafenib group (4.3 months). The percentage of grade 3 or 4 adverse events was similar between the treatment groups, although grade 3 or 4 hypertension occurred in 15.2% of the atezolizumab–bevacizumab group.