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Résumé : This chapter explores the complex interplay between gut microbiota (GM), immune checkpoint inhibitors, and HCC. HCC, the most common form of primary liver cancer, often arises from chronic liver diseases influenced by the gut-liver axis. Dysbiosis of the GM—characterized by imbalances in GM populations—has been linked to liver inflammation, fibrosis, and tumor progression. This chapter highlights the critical role GM play in modulating immune responses, particularly in the efficacy of ICIs. Beneficial bacteria such as Akkermansia muciniphila and Bifidobacterium have been shown to enhance ICI effectiveness, while microbial imbalances can lead to poor treatment outcomes. Emerging therapeutic strategies, including fecal microbiota transplantation (FMT), probiotics, and prebiotics, offer promising approaches to restoring GM balance and improving ICI responses in HCC patients. The chapter also discusses future research directions, emphasizing the need for personalized GM-based therapies and large-scale clinical trials to validate these findings. By harnessing the GM, there is potential to significantly enhance the efficacy of immunotherapy for HCC, offering new hope for patients facing this aggressive cancer.