Purpose Patients with hepatocellular carcinoma may experience poor sleep quality following Transarterial Chemoembolization (TACE). This study aimed to identify factors influencing sleep quality in patients undergoing transarterial chemoembolization. Methods The study participants comprised 49 patients who underwent TACE and 45 nurses who cared for them. Patient data were collected through a face-to-face survey before and after TACE, as well as a review of electronic medical records. Data from nurses were collected using an online survey. Results The mean sleep quality score of patients with hepatocellular carcinoma undergoing TACE was 5.04±1.76. Sleep quality was negatively correlated with the number of antipyretics used (r=-.31, p=.029), anxiety (r=-.40, p=.004), postembolization syndrome (r=-.30, p=.034), and fatigue (r=-.63, p<.001), and positively correlated with the nurse’s perception of patient’s fatigue (r=.45, p=.001). In multiple regression analysis, fatigue (β=-.47, p=.001) and the number of antipyretics used (β=-.33, p=.005) explained 43.5% of the variance in patients’ sleep quality. Conclusion The sleep quality of patients undergoing TACE was found to be relatively low. Fatigue affects sleep quality, with more fatigued patients exhibiting poorer sleep quality. Therefore, nurses must pay attention to patient fatigue and anxiety and provide more comfortable nursing care.