Abstract Introduction Regorafenib remains the standard and widely used second‐line strategy for advanced hepatocellular carcinoma (HCC). There is still a lack of large‐scale multicenter real‐world evidence concerning the concurrent use of regorafenib with immune checkpoint inhibitors (ICI). This study aims to evaluate whether combining regorafenib with ICI provides greater clinical benefit than regorafenib monotherapy as second‐line therapy for advanced HCC under real‐world circumstances. Patients and Methods The study included 208 patients from five medical facilities. One hundred forty‐three patients received regorafenib plus ICI combination therapy, while 65 patients received regorafenib monotherapy. Propensity score matching (PSM) analysis was employed. Results The regorafenib plus ICI group demonstrated significantly higher objective response rate (24.3% vs. 10.3%, after PSM, p = 0.030) and disease control rate (79.4% vs. 50.0%, after PSM, p