Coarsening of liver echogenicity is defined as increased echogenicity of the liver parenchyma and uneven distribution of echoes compared to a normal liver on ultrasound examination. Normally, the liver is characterized by homogeneous isoechoic echoes. When the liver echoes are thickened, the ultrasound beam encounters some rough tissues or lesions, and the acoustic impedance difference increases, resulting in localized thickening of the echoes. The coarsening of liver echoes usually suggests that the liver has been damaged to a certain extent, such as cirrhosis and liver cancer. Cirrhosis can be characterized by thickening and enhancement of liver echoes with uneven distribution. Diffuse hepatocellular carcinoma may also show thickening and uneven distribution of echoes in the liver. If liver echogenicity is present, it is recommended to consult a doctor promptly to clarify the cause of echogenicity.