〔Abstract〕 Objective To investigate the expression, synergistic relationship and clinical significance of alcohol dehydrogenase(ADH1A) and vascular endothelial growth factor-A(VEGFA) in hepatocellular carcinoma(HCC). Methods The expression and correlation of ADH1A and VEGFA in HCC and adjacent normal tissues were analyzed by GEPIA. TCGA and GSEA were used to analyze the pathway of ADH1A in HCC. The clinical and pathological data of 84 patients with HCC were collected, and 54 patients with paracancer normal tissue samples were selected as controls to analyze the correlation between ADH1A and VEGFA and clinicopathological parameters of HCC. Immunohistochemistry was used to detect the protein expression of ADH1A and VEGFA in cases and controls, and the correlation between the expression of ADH1A and VEGFA and the clinical progression and prognosis of patients with HCC was analyzed based on clinical pathological parameters and Kaplan-Meier. Results Bioinformatics analysis found that ADH1A was low-expressed in HCC and VEGFA was highly expressed in HCC, and there was a negative correlation between the two(P<0.001); immunohistochemical detection results showed that the expression of ADH1A in HCC tissue was lower than that in normal tissue adjacent to cancer(P<0.01) while the expression rate of VEGFA in HCC tissue was significantly higher than that of normal tissue adjacent to cancer(P<0.01); The recurrence rate of vascular thrombus and HCC patients in HCC group with high expression of ADH1A was lower(P<0.05). The proportion of tumor diameter>5 cm, high TNM stage, microsatellite and G2-G3 differentiation in HCC tissues in VEGFA high expression group was higher(P<0.05). Kaplan-Meier survival analysis showed that patients with high ADH1A expression and low VEGFA expression had a higher five-year survival rate. Conclusion Low expression of ADH1A and high expression of VEGFA in tumor tissues of patients with HCC indicate tumor progression and can be used as one of the prognostic evaluation indicators for patients with HCC.