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Background: Major society guidelines recommend transarterial chemoembolization (TACE) as the standard of care for intermediate-stage hepatocellular carcinoma (HCC) patients. However, predicting treatment response remains challenging., Aims: As artificial intelligence (AI) may predict therapeutic responses, this systematic review aims to assess the performance and effectiveness of radiomics and AI-based models in predicting TACE outcomes in patients with HCC., Methods: A systemic search was conducted on Medline and Embase databases from inception to 7th April 2024. Included studies generated a predictive model for TACE response and evaluated its performance by area under the curve (AUC), specificity, or sensitivity analysis. Systematic reviews, meta-analyses, case series and reports, pediatric, and animal studies were excluded. Secondary search of references of included articles ensured comprehensiveness., Results: 64 articles, with 13,412 TACE-treated patients, were included. AI in pre-treatment CT scans provided value in predicting the efficacy of TACE in HCC treatment. A positive association was observed for AI in pre-treatment MRI scans. Models incorporating radiomics had numerically better performance than those incorporating manual measured radiological variables. 39 studies demonstrated that combined predictive models had numerically better performance than models based solely on imaging or non-imaging features., Conclusion: A combined predictive model incorporating clinical features, laboratory investigations, and radiological characteristics may effectively predict response to TACE treatment for HCC., Competing Interests: Declarations. Conflict of interest: DQH served on the advisory board for Gilead and Roche. RK receives travel grants from Gilead and AbbVie. Ethical approval: The study was conducted in accordance with the Declaration of Helsinki. The study was exempt from IRB review was no confidential patient information was involved., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)