We evaluated the safety and efficacy of hypofractionated radiotherapy (HFRT) combined with tyrosine kinase inhibitors (TKIs) in patients with pulmonary metastases after orthotopic liver transplantation (OLT) for hepatocellular carcinoma (HCC). Twenty-five patients with lung metastases after OLT for HCC who underwent HFRT using helical tomotherapy concomitantly with TKIs (sorafenib or lenvatinib) were retrospectively. The primary endpoint was progression-free survival (PFS). The secondary endpoints were overall survival (OS), local control rate (LCR), objective response rate (ORR), and treatment-related side effects. The median follow-up time was 35.5 months, with a median interval from OLT to lung metastasis of 15.3 months. The median PFS and OS were 9.9 and 32.7 months, respectively. The 1-, 2-, and 3-year PFS and OS rates were 36.0%, 16.0%, and 12.0%, and 84.0%, 52.0%, and 20.0%, respectively. The LCR of pulmonary metastases at 1 year was 100%, whereas the two-year LCR was 76.9%. The 1- and 2- year ORRs were 95.2% and 69.2%, respectively, with no grade > 2 adverse events. Radiation pneumonitis was observed in 17 patients (68.0%). Grade 1 pneumonitis occurred in 15 patients (60.0%), and grade 2 pneumonitis occurred in 2 patients (8.0%). The combination therapy of HFRT with TKIs is a feasible, safe, and promising approach in the treatment of pulmonary metastases for HCC after OLT.