ObjectiveTo exploring the technical feasibility and safety of transradial sheathless microcatheter- hepatic arterial infusion chemotherapy (TRSM-HAIC) for malignant liver tumors. MethodsThe clinical data of patients with malignant liver tumors who underwent TRSM-HAIC in the Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, from November 2025 to March 2026, were retrospectively collected. The recorded parameters included procedural core metrics (such as puncture success rate, technical success rate, total procedure time), perioperative complications (according to CIRSE classification), postoperative recovery outcomes (immobilization time, hospital stay), and radial artery patency. ResultsA total of 20 patients underwent 36 sessions of TRSM-HAIC. The 36 sessions of TRSM-HAIC performed on 20 patients were all completed successfully. Both the puncture success rate and the technical success rate reached 100%, with no case requiring conversion to an alternative access route. The total procedure time was (40.5±12.8) min, with a median of 38.0 min. The median time from puncture to successful microcatheter placement in the hepatic artery was 4.5 min. During the perioperative period, only one minor puncture site hematoma (CIRSE grade 1 complication) was observed. No complications such as severe hemorrhage, hematoma, vascular spasm, dissection, or thrombosis occurred. No strict immobilization was required postoperatively and the postprocedural hospital stay was (4.5±1.2) d, with a median of 4 d. All 12 patients who required repeat treatment chose to continue with this method, and no new vascular complications arose during subsequent sessions. All patients maintained radial artery patency after the procedure. ConclusionsTRSM-HAIC is a safe and feasible innovative interventional technique. Its advantages include a 100% technical success rate, a low complication rate, and rapid postoperative recovery, providing a new minimally invasive option for malignant liver tumors. This is particularly relevant for patients requiring multiple interventional therapies or those unable to tolerate prolonged immobilization. Its long-term vascular protective effect and oncological outcomes warrant further validation in larger cohorts with extended follow-up.