Hepatocellular carcinoma (HCC) is one of the most common malignant tumors in the world, and surgical resection is its core treatment. However, the postoperative recurrence rate is high, and the prognosis is inferior in patients combined with microvascular invasion (MVI). And studies have shown that appropriate postoperative adjuvant therapy can delay the time to recurrence and improve overall survival in MVI-positive patients. Currently, there is no standardized postoperative adjuvant treatment for HCC with MVI, and treatment options include interventional therapy, targeted therapy, immunotherapy, radiation therapy, antiviral therapy, and the combination of the above treatments. Current evidence indicates that interventional therapies significantly improve survival outcomes in MVI-positive patients, while combination therapies involving interventional approaches demonstrate advantages in reducing early recurrence rates. However, the long-term survival benefits remain uncertain due to a lack of high-quality multicenter studies. Large-scale prospective clinical trials are required to further validate the efficacy and safety of interventional-based combination treatment strategies. In this article, we review the research progress of postoperative adjuvant interventional-related treatment for patients with MVI-positive HCC after surgery.