Objective To study the evaluation value of functional CT in relationship between hepatic functional reserve and interventional therapy risk in patients with liver cancer. Methods Sixty-four patients with primary hepatic cancer treated were selected in the Fouth Affiliated Hospital Of Guangzhou Medical University and the Second Affiliated Hospital of Guangzhou Medical University from Mar. 2012 to Oct. 2015. All clinical treatment and CT image data were persisted. All patients were treated with chemotherapy hepatic artery embolization (TACE) interventional therapy, and before TACE dual-phase enhancement and CT grading of liver cirrhosis were performed. Serum total bilirubin (TBIL), serum albumin (ALB) and other indicators were detected to evaluate damage of liver function 1 months after TACE, after TACE a retrospective observation of CT image data was carried out in severe damage of liver function group (group A, 23 cases) and mild damage of liver function group (group B, 41 cases), the differences of 2-year survival rate and indocyanine green retention rate (ICGR15) of different CT grading of liver cirrhosis patients were further compared. Results There were significant differences in CT scan hepatic perfusion parameters HAP, PVP, TLP, HBF in the group A and group B before TACE (P<0.05). CT grading of liver cirrhosis was as follow: grade I 12 cases, grade II 28 cases, grade III 16 cases, grade IV 8 cases, prognosis analysis showed that ICGR15 and 2-year follow-up survival rate of CT liver cirrhosis grade I-II patients were respectively (7.45±2.14)% and 72.5% (29/40) which were significantly better than those in grade III—IV patients (16.22±3.16)% and 45.8% (11/24) (P<0.05). Conclusion Functional CT scan hepatic perfusion parameters and CT grading of liver cirrhosis can not only evaluate hepatic functional reserve and TACE risk, but also provide important evaluation basis for hepatic functional reserve and clinical treatment.