Hepatocellular carcinoma (HCC) has a great tendency toward venous invasion; however, metastatic HCC invasion into the right atrial cavity was rarely reported. We herein report a rare case of right atrial invasion from hepatocellular carcinoma in a 50-year-old man with history of alcoholic liver cirrhosis, and later diagnosed as hepatocellular carcinoma. Because of the patient did not wish any invasive therapy, he received compassionate thalidomide therapy only. Two weeks later, he died of circulatory collapse. Cardiac involvement of HCC should be considered when a patient with a history of chronic hepatic disease presents with unexplained cardiac symptoms or refractive leg edema. Keeping a low threshold for cardiac image surveillance is suggested.