Motivated by recent transport experiments, we theoretically study the quantum Hall effect in topological semimetal films. Owing to the confinement effect, the bulk subbands originating from the chiral Landau levels establish energy gaps that have quantized Hall conductance and can be observed in relatively thick films. We find that the quantum Hall state is strongly anisotropic for different confinement directions not only due to the presence of the surface states but also because of the bulk chiral Landau levels. As a result, we re-examine the quantum Hall effect from the surface Fermi arcs and chiral modes in Weyl semimetals and give a more general view into this problem. Besides, we also find that when a topological Dirac semimetal is confined in its rotational symmetry axis, it hosts both quantum Hall and quantum spin Hall states, in which the helical edge states are protected by the conservation of the spin-$z$ component.