Background: Hepatocellular carcinoma (HCC) is a common primary liver malignancy. Despite advancements in treatment, HCC often has a poor prognosis because of frequent recurrence and metastasis. Hematogenous metastasis to the gastrointestinal tract is uncommon and metastasis to the small intestine is particularly rare. Method: We present the case of a 72-year-old man with HCC who developed small bowel metastasis and intussusception. A literature review was conducted using the keywords “hepatocellular carcinoma,” “small bowel metastasis,” and “gastrointestinal tract metastasis” in the MEDLINE (PubMed) database. Non-English language reports were excluded. Results: Fifteen cases of HCC metastasis to the small intestine were retrieved from the literature, with two cases diagnosed post-mortem. Of the 13 reported cases and the present case, 10 cases involved male patients. The most common symptom was gastrointestinal bleeding, which occurred in 50% of cases, followed by elevated tumor markers and bowel obstruction. Imaging modalities such as computed tomography and positron emission tomography were typically used for a diagnosis, whereas endoscopic examination was used for detecting duodenal tumors. The metastatic tumors exhibited various morphologies across all three segments of the small intestine. Portal vein thrombosis or tumor invasion was reported in only one-half of the cases. Surgical resection remains the most effective treatment for isolated small bowel metastases. Conclusion: Small intestine metastasis from HCC, although rare, should be considered in patients with gastrointestinal symptoms or unexplained elevated tumor markers. Surgical resection is the most effective treatment approach, with minimally invasive and endoscopic techniques available for select cases.