Active liver disease, in clinical practice, usually means that the hepatitis B virus is in an active phase and requires prompt treatment to avoid exacerbation, which can lead to cirrhosis. Patients usually present with abnormal liver function, and imaging may be normal or abnormal. In the case of abnormalities, often imaging shows poorly defined vascular texture and coarse echogenicity in the hepatic region. It also shows varying degrees of elevated aminotransferases, and even elevated bilirubin, and altered albumin, which manifests as the presence of hypoproteinemia. Histologic examination of the liver shows that patients usually have different degrees of liver inflammation and fibrosis, all of which represent hepatitis in the active stage and require further clarification of the etiology.